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' Nopioids ' for Chronic Pain: Only When Nothing Else Works ' Nopioids ' for Chronic Pain: Only When Nothing Else Works
Dr Neha Pathak interviews Dr Daniel Clauw about how opioids fit into the treatment armamentarium when managing chronic pain.Medscape Internal Medicine
Source: Medscape Today Headlines - September 20, 2023 Category: Consumer Health News Tags: Internal Medicine Commentary Source Type: news
Africa: Chronic Pelvic Pain Affects Up to 26 Percent of Women - Our Latest Research Brings Us Closer to Better Treating It
[The Conversation Africa] Chronic pelvic pain affects between 5% and 26% of women worldwide. It can be associated with conditions such as endometriosis (where tissue resembling the lining of the womb is found outside the womb) and interstitial cystitis (bladder pain syndrome). Some women also have chronic pelvic pain without a specific cause.
Source: AllAfrica News: Health and Medicine - September 20, 2023 Category: African Health Tags: Africa Health and Medicine Women and Gender Source Type: news
Intussusception as a complication of idiopathic nephrotic syndrome
A 19-year-old male patient presented with abdominal pain associated with a relapse of minimal change disease (serum creatinine: 90 μmol/l; albumin: 1.6 g/dl; proteinuria: 7.8 g/g). A right iliac fossa ileo–ileal intussusception was found on the computed tomography (CT) scan (Figure 1). The pain subsided with administration of paracetamol but recurred 2 days later. A second CT scan showed 2 other right lumbar jejuno–jejuna l intussusceptions, and 1 upper-left-quadrant ileo–ileal intussusception, but the right iliac fossa ileo–ileal intussusception was no longer visible (Figure 2).
Source: Kidney International - September 20, 2023 Category: Urology & Nephrology Authors: Fanny Dreant, Benedicte Sautenet, Christelle Barbet, Jean-Michel Halimi Tags: Nephrology Image Source Type: research
Proximalization of Inflow With Adjunct Arterial Pressure Measurement for Hemodialysis Access-induced Digital ischemia
Hemodialysis access-induced distal ischemia (HAIDI) is an uncommon, yet potentially devastating complication of hemodialysis access surgery. Symptomatic HAIDI affects about 10% of dialysis patients and can present with mild hand coolness, rest pain, or tissue loss. Volume flow determines the management of HAIDI and may involve banding; revision using distal inflow; proximalization of inflow, distal revascularization; interval ligation; or access ligation. This case report highlights the use of proximalization of inflow with adjunctive intraoperative measurement of distal perfusion to treat severe HAIDI.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Vincent Narvaez, Samuel Paci, Jeffrey Silpe, Gregg Landis, Yana Etkin Tags: Dialysis Access Source Type: research
Robotic Median Arcuate Ligament Release
We present the case of a patient with atypical symptoms found to have MALS and underwent minimally invasive robotic surgical treatment.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Katherine McMackin, Catherine Zhang, Rebecca Platoff, David Shersher Tags: Other Source Type: research
Comparing Pain and Other Patient-reported Outcomes in Carotid Artery Revascularization: Carotid Endarterectomy vs Transcarotid Artery Revascularization
To assess the difference in patient-reported outcomes between carotid endarterectomy (CEA) and transcarotid artery revascularization (TCAR) at a single institution within the first 2 years of TCAR implementation. Primary outcomes studied were patient-reported pain scores and use of postoperative opioid analgesia.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Trevor Dorey, Sara Parmiter, Jamie Sanders, Justin Turcotte, Geetha Jeyabalan Tags: Carotid Artery Interventions Source Type: research
Contemporary Outcomes of Surgical Decompression for Functional Popliteal Entrapment Syndrome
Functional popliteal entrapment syndrome (FPES) is an underrecognized source of leg pain caused by dynamic compression of the popliteal vessels by surrounding musculature in the absence of anatomic abnormality. Late recognition and difficulty capturing this entity across imaging modalities can lead to significant morbidity in an often young and active patient population. Surgical outcomes and optimal diagnostic strategies remain uncertain.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: James J. Fitzgibbon, Patrick Heindel, Bernadette Goudreau, Brittany Aicher, Bryan Dieffenbach, Matthew T. Menard Source Type: research
Digital sedation: A new revolution in the management of superficial venous insufficiency
Thermal endovenous treatments with tumescence for superficial venous insufficiency (SVI) are now recommended in a large majority of indications. Their use under local tumescent anesthesia (LTA) and neuroleptanalgesia (NL) has become common. NL (benzodiazepine/psychotropic/opioid combination) is not devoid of adverse effects, but pure LTA remains difficult for patients to accept. Digital sedation (DS), by means of visual and auditory loops dedicated to a brain disconnection, using the same channels as those conveying pain, could make it possible to do away with NL chemical sedation.
Source: Annals of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Lauranne Matray, Arnaud Salces Y Nedeo, Charles Neveu, Florent Charot Source Type: research
Arterial angioplasty under local anesthesia in everyone without unpleasant surprises: the revolution of digital sedation
Lower extremity revascularization is performed percutaneously. Local anesthesia (LA) with neuroleptanalgesia (NA) or general anesthesia (GA) ensure patient comfort and allows proper procedure completion. However, NA and GA are not devoid of adverse effects in elderly and poly-pathological patients. Digital sedation (DS), through visual and auditory loops dedicated to brain disconnection, saturating the channels carrying the pain, do away with chemical sedation while guaranteeing the comfort of the patients and the smooth running of the procedure.
Source: Annals of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Lauranne Matray, Charles Neveu, Florent Charot, Bertrand Goupil Source Type: research
Which psychological and psychosocial constructs are important to measure in future tendinopathy clinical trials? A modified international Delphi study with expert clinician/researchers and people with tendinopathy
J Orthop Sports Phys Ther. 2023 Sep 20:1-29. doi: 10.2519/jospt.2023.11903. Online ahead of print.ABSTRACTOBJECTIVE: to identify which psychological and psychosocial constructs to include in a core outcome set to guide future clinical trials in the tendinopathy field. DESIGN: modified International Delphi study. METHODS: In three online Delphi rounds, we presented 35 psychological and psychosocial constructs to an international panel of 38 clinician/researchers and people with tendinopathy. Using a 9-point Likert scale (1 - not important to include, 9 -critical to include), consensus for construct inclusion required ≥70%...
Source: Physical Therapy - September 20, 2023 Category: Physiotherapy Authors: Carl Stubbs Sean Mc Auliffe Ruth L Chimenti Brooke K Coombes Terry Haines Luke Heales Robert Jan Vos Greg Lehman Adrian Mallows Lori A Michner Neal B W Millar Seth O'Neill Kieran O'Sullivan Melanie Plinsinga Michael Rathleff Ebonie Rio Megan Ross Jean-Seb Source Type: research
VEIN STEP: A Prospective, Observational, International Study to Assess Effectiveness of Conservative Treatments in Chronic Venous Disease
CONCLUSION: In this prospective study conducted in the real-world setting, treatment with conservative therapy, in particular MPFF, was associated with meaningful improvements in the clinical signs and symptoms of disease as well as in quality of life in patients with CVD.TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04574375.PMID:37728696 | DOI:10.1007/s12325-023-02643-6
Source: Adv Data - September 20, 2023 Category: Epidemiology Authors: Zoubida Tazi Mezalek Toni Feodor Larisa Chernukha Zhong Chen Ana Rueda Ignacio Escotto S ánchez Alejandro Jos é González Ochoa Joanna Chirol Vanessa Blanc-Guillemaud Caroline Lohier-Durel Jorge Hernando Ulloa Source Type: research
Pain management for liver transplant recipients
We present current evidence-based literature that reviews optimal pain management strategies for this challenging patient demographic.RECENT FINDINGS: Multiple studies have shown that thoracic epidurals provide superior pain control in open hepatic resections. Recent data suggests thoracic epidurals may be safely considered in select liver transplant recipients with normal preoperative coagulation status; however, this evidence is limited, and further studies are needed. When the risks of coagulopathy prohibit epidural placement, truncal blocks such as transversus abdominis plane blocks or quadratus lumborum blocks and abd...
Source: Current Opinion in Organ Transplantation - September 20, 2023 Category: Transplant Surgery Authors: Simrat Kaur Patrick Henthorn Adrian Hendrickse Source Type: research
Which psychological and psychosocial constructs are important to measure in future tendinopathy clinical trials? A modified international Delphi study with expert clinician/researchers and people with tendinopathy
J Orthop Sports Phys Ther. 2023 Sep 20:1-29. doi: 10.2519/jospt.2023.11903. Online ahead of print.ABSTRACTOBJECTIVE: to identify which psychological and psychosocial constructs to include in a core outcome set to guide future clinical trials in the tendinopathy field. DESIGN: modified International Delphi study. METHODS: In three online Delphi rounds, we presented 35 psychological and psychosocial constructs to an international panel of 38 clinician/researchers and people with tendinopathy. Using a 9-point Likert scale (1 - not important to include, 9 -critical to include), consensus for construct inclusion required ≥70%...
Source: Health Physics - September 20, 2023 Category: Physics Authors: Carl Stubbs Sean Mc Auliffe Ruth L Chimenti Brooke K Coombes Terry Haines Luke Heales Robert Jan Vos Greg Lehman Adrian Mallows Lori A Michner Neal B W Millar Seth O'Neill Kieran O'Sullivan Melanie Plinsinga Michael Rathleff Ebonie Rio Megan Ross Jean-Seb Source Type: research
Association of participants who screened positive for night eating syndrome with physical health, sleep problems, and weight status in an Australian adult population
CONCLUSIONS: Several physical health problems were found to be significantly associated with the spNES group including sleep problems, increased BMI, increased levels of pain and lower self-reported physical health-related quality of life. Consequently, future research exploring the complex interaction between NES and these medical conditions may provide further insight into the diagnosis, screening tools and management of NES. Additionally, this study highlights the need for future studies which use larger population-based samples.LEVEL OF EVIDENCE: Level III. Evidence obtained from well-designed cohort or case-control an...
Source: Eating and weight disorders : EWD - September 20, 2023 Category: Eating Disorders & Weight Management Authors: Sai Janani Sakthivel Phillipa Hay Stephen Touyz David Currow Haider Mannan Source Type: research
Microfragmented adipose tissue in the treatment of a full-thickness supraspinatus tear: a case report
Regen Med. 2023 Sep 20. doi: 10.2217/rme-2023-0086. Online ahead of print.ABSTRACTA 70-year-old female presented with an 8-month history of right anterior shoulder pain and weakness, unresolved with conservative management. Among other shoulder pathology, the patient was diagnosed with a full-thickness supraspinatus tear and elected to proceed with the microfragmented adipose tissue procedure to treat the injured tendon and nearby relevant structures. Improvements in pain and function were documented along with progressive healing of the supraspinatus on ultrasound and MRI following the procedure. This case demonstrates th...
Source: Regenerative Medicine - September 20, 2023 Category: Genetics & Stem Cells Authors: John L Ferrell Alanna Dodson Joshua Martin Source Type: research
