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https://www.readbyqxmd.com/read/27919368/clinical-reasoning-in-the-context-of-active-decision-support-during-medication-prescribing
#1
Jan Horsky, Jos Aarts, Leonie Verheul, Diane L Seger, Heleen van der Sijs, David W Bates
OBJECTIVE: Describe and analyze reasoning patterns of clinicians responding to drug-drug interaction alerts in order to understand the role of patient-specific information in the decision-making process about the risks and benefits of medication therapy. Insights could be used to inform the design of decision-support interventions. METHODS: Thirty-two clinicians working with five EHRs in two countries completed sets of six medication orders each and responded to high- and low-severity drug-drug interaction alerts while verbalizing their thoughts in a standard think-aloud protocol...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27906953/what-s-tramadol-got-to-do-with-it-a-case-report-of-rebound-hypoglycemia-a-reappraisal-and-review-of-potential-mechanisms
#2
Charles A Odonkor, Akhil Chhatre
BACKGROUND: Tramadol has gained traction as an analgesic of choice among pain practicing physicians. However some concerns regarding a previously unlabeled adverse reaction - hypoglycemia - have cast it in a dim light. Prior reports have noted an associated risk of hospitalization for hypoglycemia after tramadol use, but whether tramadol is the main causal agent is poorly understood and the underlying mechanisms are not well delineated. We present a unique case of rebound hypoglycemia as a variation of the theme of tramadol's adverse effect profile in a patient with type 1 diabetes mellitus, and reappraise potential mechanisms underlying this underappreciated phenomenon...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27858725/2-year-clinical-results-of-patients-with-sacroiliac-joint-syndrome-treated-by-arthrodesis-using-a-triangular-implant-system
#3
Rahel Bornemann, Philip P Roessler, Andreas Strauss, Kirsten Sander, Yorck Rommelspacher, Dieter C Wirtz, Robert Pflugmacher, Sönke P Frey
BACKGROUND: Sacroiliac joint (SIJ) syndrome can cause various symptoms and may also be one reason for persistent low back pain, especially in patients with prior spinal fusions. If conservative treatments fail to improve symptoms, arthrodesis surgery can be considered. Minimally invasive approaches have emerged recently providing a good alternative to conventional methods. A novel triangular implant system (iFuse) can achieve an arthrodesis of the SIJ without the use of additional screws or bone material...
November 4, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/27852411/-comparative-study-of-different-grading-criteria-of-sacroiliac-joint-computed-tomogrphy-in-ankylosing-spondylitis
#4
D Gao, K P Li, Q F Wen, J Zhu, J L Zhang, F Huang
Objective: To assess the value of different grading criteria of sacroiliac joint (SIJ) computed tomogrphy (CT) in ankylosing spondylitis (AS). Methods: Patients who had received SIJ CT examinations from June 2012 to December 2015 were enrolled.The CT scans were read by one rheumatologist.The difference between patients with sacroiliitis or without sacroiliitis was compared.The 1984 revision of modified New York (mNY) criteria, the criteria established by Lee (Lee criteria) and the Innsbruck criteria were used to evaluate SIJs on CT in patients with sacroiliitis...
October 25, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27824544/radionuclide-methods-in-the-diagnosis-of-sacroiliitis-in-patients-with-spondyloarthritis-an-update
#5
REVIEW
Karina Zilber, Miguel Gorenberg, Doron Rimar, Nina Boulman, Lisa Kaly, Michael Rozenbaum, Itzhak Rosner, Gleb Slobodin
Sacroiliitis, inflammation of the sacroiliac joint (SIJ), is the hallmark of ankylosing spondylitis and spondyloarthritis (SpA) in general. The arsenal of recommended diagnostic modalities for imaging of the SIJ is scanty and, in practice, includes only conventional X-rays and magnetic resonance imaging (MRI). This review suggests that bone scintigraphy, particularly single-photon emission computed tomography (SPECT) with calculation of indices, or SPECT in combination with low-dose computed tomography (CT) can be a sensitive and specific tool for the diagnosis of sacroiliitis and can be used as part of the individualized approach to the diagnosis of axial SpA...
October 31, 2016: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/27811527/a-cadaveric-study-evaluating-the-feasibility-of-an-ultrasound-guided-diagnostic-block-and-radiofrequency-ablation-technique-for-sacroiliac-joint-pain
#6
Shannon L Roberts, Robert S Burnham, Anne M Agur, Eldon Y Loh
BACKGROUND AND OBJECTIVES: Ultrasound (US)-guided diagnostic block/radiofrequency ablation (RFA) along the lateral sacral crest (LSC) has been proposed for managing sacroiliac joint (SIJ) pain. We sought to investigate (1) ease of visualization of bony landmarks using US; (2) consistency of US-guided needle placement along the LSC; and (3) percentage of the posterior sacral network (PSN) innervating the SIJ complex that would be captured if an RFA strip lesion were created between the needles...
November 2, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27799571/evaluation-of-sacroiliac-joint-mri-for-pelvic-venous-congestion-signs-in-women-clinically-suspected-of-sacroiliitis
#7
Canan Cimsit, Tevfik Yoldemir, Derya Tureli, Mustafa Erkin Aribal
BACKGROUND: Pelvic congestion syndrome (PCS) is a commonly overlooked condition which is a potential cause of chronic pelvic pain. Magnetic resonance imaging (MRI) of the sacroiliac joint (SIJ) may demonstrate unexpected conditions that can mimic sacroiliitis (SI). Awareness of MRI-defined pelvic venous congestion (PVC) may help in identifying PCS, where vascular abnormality may be the sole manifestation of SIJ pain. PURPOSE: To detect incidental MRI-defined PVC in patients who underwent SIJ-MRI for presumed SI and define the variance of its incidence...
October 31, 2016: Acta Radiologica
https://www.readbyqxmd.com/read/27744397/limited-reliability-of-radiographic-assessment-of-sacroiliac-joints-in-patients-with-suspected-early-spondyloarthritis
#8
Alice Ashouri Christiansen, Oliver Hendricks, Dorota Kuettel, Kim Hørslev-Petersen, Anne Grethe Jurik, Steen Nielsen, Kaspar Rufibach, Anne Gitte Loft, Susanne Juhl Pedersen, Louise Thuesen Hermansen, Mikkel Østergaard, Bodil Arnbak, Claus Manniche, Ulrich Weber
OBJECTIVE: To determine the reproducibility of evaluation of sacroiliac joint (SIJ) radiographs among readers with varying levels of experience, and to identify potential drivers of disagreement in classification among 5 predefined radiographic lesion types. METHODS: The study sample consisted of 104 consecutive patients aged 18-40 with low back pain ≥ 3 months of duration who met the Assessment of SpondyloArthritis international Society (ASAS) definition for a positive SIJ magnetic resonance imaging, or were HLA-B27-positive and had ≥ 1 spondyloarthritis (SpA)-related clinical/laboratory feature according to the ASAS classification criteria for axial SpA...
October 15, 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27742020/imaging-scoring-methods-in-axial-spondyloarthritis
#9
Xenofon Baraliakos, Juergen Braun
Inflammatory and chronic structural changes are objective signs of axial spondyloarthritis. In the sacroiliac joints (SIJs), inflammation (sacroiliitis) can be visualized as bone marrow edema, whereas chronic structural changes are visualized as fat metaplasia, erosions, sclerosis, or ankylosis in the area of the SIJ. In the spine, bone marrow edema in the vertebral bodies represents spondylitis but can also affect the facet and the costovertebral and costotransverse joints (arthritis), whereas structural changes are visualized as fat metaplasia, sclerosis or syndesmophytes and ankylosis at the vertebral edges...
November 2016: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/27738191/a-new-sacroiliac-joint-injection-technique-and-its-short-term-effect-on-chronic-sacroiliac-region-pain
#10
Kyung Hee Do, Sang Ho Ahn, Rodney Jones, Sung Ho Jang, Su Min Son, Dong Gyu Lee, Hee Kyung Cho, Gyu Sik Choi, Yun-Woo Cho
OBJECTIVES: Sacroiliac joint (SIJ) injections have been used to provide short-term relief of SIJ pain. In this study, the authors investigated a new technique using a superior approach. METHODS: Twenty four patients with chronic SI joint paint were recruited. Each patient was treated with a single SIJ intra-articular injection plus a periarticular injection of local anesthetic and corticosteroid in one procedure. Technical accuracy of the intra-articular procedure was determined by having 2 independent observers review and rate the quality of arthrograms obtained...
October 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27733191/identification-of-subgroups-of-inflammatory-and-degenerative-mri-findings-in-the-spine-and-sacroiliac-joints-a-latent-class-analysis-of-1037-patients-with-persistent-low-back-pain
#11
Bodil Arnbak, Rikke Krüger Jensen, Claus Manniche, Oliver Hendricks, Peter Kent, Anne Grethe Jurik, Tue Secher Jensen
BACKGROUND: The aim of this study was to investigate subgroups of magnetic resonance imaging (MRI) findings for the spine and sacroiliac joints (SIJs) using latent class analysis (LCA), and to investigate whether these subgroups differ in their demographic and clinical characteristics. METHODS: The sample included 1037 patients aged 18-40 years with persistent low back pain (LBP). LCA was applied to MRI findings of the spine and SIJs. The resulting subgroups were tested for differences in self-reported demographic and clinical characteristics...
October 13, 2016: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/27677100/steroid-vs-platelet-rich-plasma-in-ultrasound-guided-sacroiliac-joint-injection-for-chronic-low-back-pain
#12
Varun Singla, Yatindra K Batra, Neerja Bharti, Vijay G Goni, Neelam Marwaha
BACKGROUND: Despite widespread use of steroids to treat sacroiliac joint (SIJ) pain, their duration of pain reduction is short. Platelet-rich plasma (PRP) can potentially enhance tissue healing and may have a longer-lasting effect on pain. OBJECTIVES: To assess the efficacy and safety of PRP compared with methylprednisolone in ultrasound-guided SIJ injection for low back pain. STUDY DESIGN: Prospective randomized open blinded end point (PROBE) study...
September 27, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27652199/two-year-outcomes-from-a-randomized-controlled-trial-of-minimally-invasive-sacroiliac-joint-fusion-vs-non-surgical-management-for-sacroiliac-joint-dysfunction
#13
David W Polly, John Swofford, Peter G Whang, Clay J Frank, John A Glaser, Robert P Limoni, Daniel J Cher, Kathryn D Wine, Jonathan N Sembrano
BACKGROUND: Sacroiliac joint (SIJ) dysfunction is an important and underappreciated cause of chronic low back pain. OBJECTIVE: To prospectively and concurrently compare outcomes after surgical and non-surgical treatment for chronic SIJ dysfunction. METHODS: One hundred and forty-eight subjects with SIJ dysfunction were randomly assigned to minimally invasive SIJ fusion with triangular titanium implants (SIJF, n = 102) or non-surgical management (NSM, n = 46)...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27629371/referred-leg-pain-originating-from-the-sacroiliac-joint-6-month-outcomes-from-the-prospective-randomized-controlled-imia-trial
#14
Julius Dengler, Bengt Sturesson, Djaya Kools, Domenico Prestamburgo, Daniel Cher, Eddie van Eeckhoven, Emanuel Erk, Robert Pflugmacher, Peter Vajkoczy
BACKGROUND: The first results from the randomized, controlled iFuse Implant System Minimally Invasive Arthrodesis (iMIA) trial showed that minimally invasive surgical management (MISM) of low back pain originating from the sacroiliac joint (SIJ) by placing transarticular triangular titanium implants reduced pain more effectively than conservative management (CM). We now conducted a separate analysis of the iMIA data to assess whether the referred leg pain (RLP) component of SIJ-associated pain may also be affected by MISM or CM...
November 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27625495/intractable-sacroiliac-joint-pain-treated-with-peripheral-nerve-field-stimulation
#15
Shushovan Chakrabortty, Sanjeev Kumar, Deepak Gupta, Sruthi Rudraraju
As many as 62% low back pain patients can have sacroiliac joint (SIJ) pain. There is limited (to poor) evidence in regards to long-term pain relief with therapeutic intra-articular injections and/or conventional (heat or pulsed) radiofrequency ablations (RFAs) for SIJ pain. We report our pain-clinic experience with peripheral nerve field stimulation (PNFS) for two patients of intractable SIJ pain. They had reported absence of long-term pain relief (pain relief >50% for at least 2 weeks postinjection and at least 3 months post-RFA) with SIJ injections and SIJ RFAs...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27608795/spine-and-sacroiliac-joints-on-magnetic-resonance-imaging-in-patients-with-early-axial-spondyloarthritis-prevalence-of-lesions-and-association-with-clinical-and-disease-activity-indices-from-the-italian-group-of-the-space-study
#16
M Lorenzin, A Ortolan, P Frallonardo, S Vio, C Lacognata, F Oliviero, L Punzi, R Ramonda
Our aim was to determine the prevalence of spine and sacroiliac joint (SIJ) lesions on magnetic resonance imaging (MRI) in patients with early axial spondyloarthritis (axSpA) and their correlation with disease activity indices. Sixty patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years), attending the SpA-clinic of the Unità Operativa Complessa Reumatologia of Padova [SpondyloArthritis-Caught-Early (SPACE) study], were studied following a protocol including physical examination, questionnaires, laboratory tests, X-rays and spine and SIJ MRI...
2016: Reumatismo
https://www.readbyqxmd.com/read/27605679/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-x-sacroiliac-joint-syndrome
#17
Patrick J Polsunas, Gwendolyn Sowa, Julie M Fritz, Angela Gentili, Natalia E Morone, Srinivasa Naga Raja, Eric Rodriguez, Kenneth Schmader, Joel D Scholten, Debra K Weiner
OBJECTIVE: To present an algorithm of sequential treatment options for managing sacroiliac joint (SIJ) pain in the setting of chronic low back pain (CLBP) in the older adult. This is the tenth part in a series, and includes an illustrative clinical case. METHODS: The stepped care drug table and evaluation and treatment algorithm were created following a thorough literature review of approaches and subsequent analysis through a modified Delphi process. The principal investigator developed the initial draft, which was refined for content by an interdisciplinary panel of five experts...
September 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27603311/analysis-of-the-sacroiliac-joint-vacuum-phenomenon-in-paediatric-patients
#18
Sun-Kyoung You, Hyo-Jin Lee, Jeong-Eun Lee, Jongchul Kim, So-Mi Lee, Hyun-Hae Cho
OBJECTIVE: To assess the incidence of the sacroiliac joint vacuum phenomenon (SIJ VP) in paediatric patients and the relationship between the presence of VP and clinical factors such as age, sex and body mass index (BMI). METHODS: We retrospectively reviewed clinical data and imaging findings of 60 patients who underwent abdominopelvic CT (AP CT) between January and June 2015. Patients were divided into VP group and non-VP group based on the presence/absence of VP, and the groups were compared...
November 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27567387/impact-of-sacropelvic-fixation-on-the-development-of-postoperative-sacroiliac-joint-pain-following-multilevel-stabilization-for-degenerative-spine-disease
#19
T Finger, S Bayerl, M Bertog, M Czabanka, J Woitzik, P Vajkoczy
OBJECTIVE: We hypothesised, that the inclusion of the ilium for multilevel lumbosacral fusions reduces the incidence of postoperative sacroiliac joint (SIJ) pain. The primary objective of this study was to compare the frequency of postoperative SIJ pain in patients undergoing multilevel stabilization with and without sacropelvic fixation for multilevel degenerative spine disease. In addition, we aimed at identifying factors that may predict the worsening or new onset of postoperative SIJ pain...
November 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27551419/-simplicity-radiofrequency-neurotomy-of-sacroiliac-joint-a-real-life-1-year-follow-up-uk-data
#20
Vinay S Anjana Reddy, Chhaya Sharma, Kuang-Yi Chang, Vivek Mehta
BACKGROUND: Sacroiliac joint (SIJ) pain is considered to be the third most common cause of low back pain with the prevalence of 13-25% in all low back pain patients. Its diagnosis and treatment remain a challenge with the poor evidence base for interventional procedures. Patients with SIJ pain experience a low quality of life, worse than some of the chronic health conditions. Simplicity radiofrequency (RF) neurotomy is a novel technique which tackles some of the problems faced by conventional RF neurotomy and may offer better results in managing pain arising from SIJ...
May 2016: British Journal of Pain
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