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preoperative withdrawal

Brian M Ilfeld, John J Finneran, Rodney A Gabriel, Engy T Said, Patrick L Nguyen, Wendy B Abramson, Bahareh Khatibi, Jacklynn F Sztain, Matthew W Swisher, Pia Jaeger, Dana C Covey, Matthew J Meunier, Eric R Hentzen, Catherine M Robertson
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain following knee and foot surgery. However, it remains unknown if this analgesic technique may be used in ambulatory patients following upper extremity surgery. The purpose of this proof-of-concept study was to investigate various lead implantation locations and evaluate the feasibility of using percutaneous brachial plexus PNS to treat surgical pain following ambulatory rotator cuff repair in the immediate postoperative period...
February 15, 2019: Regional Anesthesia and Pain Medicine
Georgi Tchernev, Ivanka Temelkova
BACKGROUND: Drug-induced melanoma is a topic, concept or "reality" becoming more and more popular as the list of drugs considered as potential inducers of cutaneous melanoma is constantly growing. Interesting and current at the moment is the question/dilemma of "Irbesartan induced melanomas" and "Valsartan induced melanomas"! The following questions are without answers: 1) the general risk which angiotensin receptor blockers contain for potentiating the carcinogenesis and cancer development (as a whole); 2) available officialized data for withdrawal from the market of products with valsartan and irbesartan due to detected potential carcinogens-NDMA/NDEA, and 3) the missing official information on the most likely forms of cancer potentiated by these drugs...
January 15, 2019: Open Access Macedonian Journal of Medical Sciences
Sun Ah Choi, Soo Yeon Kim, Woo Joong Kim, Young Kyu Shim, Hunmin Kim, Hee Hwang, Ji Eun Choi, Byung Chan Lim, Jong Hee Chae, Sangjoon Chong, Ji Yeoun Lee, Ji Hoon Phi, Seung Ki Kim, Kyu Chang Wang, Ki Joong Kim
BACKGROUND AND PURPOSE: This study investigated the seizure recurrence rate and potential predictors of seizure recurrence following antiepileptic drug (AED) withdrawal after resective epilepsy surgery in children with focal cortical dysplasia (FCD). METHODS: We retrospectively analyzed the records of 70 children and adolescents with FCD types I, II, and IIIa who underwent resective epilepsy surgery between 2004 and 2015 and were followed for at least 2 years after surgery...
January 2019: Journal of Clinical Neurology
Florin-Andrei Taran, Dorit Schöller, Katharina Rall, Silvio Nadalin, Alfred Königsrainer, Melanie Henes, Hans Bösmüller, Falko Fend, Konstantin Nikolaou, Mike Notohamiprodjo, Christian Grasshoff, Eckhard Heim, Stephan Zipfel, Norbert Schäffeler, Tamam Bakchoul, Nils Heyne, Martina Guthoff, Bernhard Krämer, Christl Reisenauer, Markus Hoopmann, Karl-Oliver Kagan, Mats Brännström, Diethelm Wallwiener, Sara Y Brucker
OBJECTIVE: To report our experience with the screening and selection of potential recipients and living donors of our uterus transplantation (UTx) program. DESIGN: Part of an observational program. SETTING: University hospital. PATIENT(S): Patients with absolute uterine factor infertility (AUFI). INTERVENTION(S): Screening by e-mail and telephone, selection during surgical consultation, and preoperative investigations according to a multistep procedure for living donation...
January 2019: Fertility and Sterility
Zhen Lai, Shi-Yuan Shi, Jun Fei, Gui-He Han, Sheng-Ping Hu
OBJECTIVE: To investigate the effect of preoperative percutaneous drainage in lumbar tuberculosis with psoas abscess, through compare the clinical efficacy of two different methods. METHODS: Thirty-six patients with lumbar tuberculosis complicated with psoas abscess in corresponding with the inclusion criteria were admitted in Zhejiang Province Traditional Chinese Medicine Hospital from January 2015 to January 2017. The patients were divided into group A and group B according to the different therapeutic methods...
November 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Raoul Verzijl, Pim J Bongers, Geetha Mukerji, Ozgur Mete, Karen M Devon, Jesse D Pasternak
A 71-year-old man with known history of atrial fibrillation (treated with routine rivaroxaban therapy) was found to have incidental biochemical elevated calcium and parathyroid hormone (PTH) levels. His physical examination demonstrated the presence of a palpable right neck mass. Subsequent imaging studies revealed a large parathyroid mass as well as multiple bone lesions, raising the suspicion of parathyroid carcinoma. The anticoagulant therapy was stopped 5 days prior to his elective surgery. The night before his elective surgery, he presented to the emergency room with profound hypocalcemia...
2018: Case Reports in Surgery
Jianjun Xue, Huili Li, Ziqing Xu, Danxu Ma, Ruijuan Guo, Kehu Yang, Yun Wang
The mechanisms underlying the pronociceptive effect of paradoxical sleep deprivation (PSD) are not fully established. The modulation of BDNF signaling-mediated descending facilitation from the rostral ventromedial medulla (RVM) of brain stem has been demonstrated in persistent pain models of inflammatory pain, but not in incisional pain model. Recent study has shown that PSD increases the expression of brain-derived neurotrophic factor (BDNF) in the brainstem structure. Therefore, in the current study, we asked whether the BDNF signaling-mediated descending facilitation was involved in the PSD-induced pronociceptive effect on incisional pain and delay the recovery period of postoperative pain in rats...
December 2018: Neurochemical Research
Ya-Ling Zhang, De-Jian Chen, Bao-Lin Yang, Tao-Tao Liu, Jia-Juan Li, Xiu-Qi Wang, Guo-Yong Xue, Zeng-Xu Liu
Schwann cell transplantation is a promising method to promote neural repair, and can be used for peripheral nerve protection and myelination. Microcapsule technology largely mitigates immune rejection of transplanted cells. We previously showed that microencapsulated olfactory ensheathing cells can reduce neuropathic pain and we hypothesized that microencapsulated Schwann cells can also inhibit neuropathic pain. Rat Schwann cells were cultured by subculture and then microencapsulated and were tested using a rat chronic constriction injury (CCI) neuropathic pain model...
November 2018: Neural Regeneration Research
Le Zhang, Xin-Yue Jiang, Dong Zhou, Heng Zhang, Shi-Min Bao, Jin-Mei Li
This study aimed to investigate the impact of timing interval to start AED withdraw (TIW) after surgery on the seizure outcome in non-neoplastic drug resistant epilepsy (DRE). TIW were divided into three groups (respectively,<1 year, 1-<2 years, and ≥2 years). The seizure outcome at the different time points after starting AED withdrawal were compared among three groups. Other factors that related to seizure recurrence and TIW were included into the multiple analysis to investigate the predictors of seizure-free...
September 13, 2018: Scientific Reports
David Yuen-Chung Chan, Steve Sik-Kwan Chan, Emily Kit-Ying Chan, Amelia Yikjin Ng, Aaron Chee-Lun Ying, Ara Cheuk-Yin Li, Candy Ching-Pik Chiu, Ning Cheung, Wai-Kit Mak, David Tin-Fung Sun, Cannon Xian-Lun Zhu, Wai-Sang Poon
Aim: The intrathecal baclofen pump is an effective treatment for spasticity. However, long-term results have reported patients' dissatisfaction and perception of disability. Potential causes include a frequent need for baclofen pump refill and risks of complications. The aim of the present study was to evaluate the long-term maintenance, complications and clinical outcome of intrathecal baclofen pumps. Patients and Methods: We conducted a 16-year retrospective cohort study of patients with spasticity treated with an intrathecal baclofen pump at a university hospital from 2000 to 2016...
August 2018: Surgical Practice
Arianna F Yanes, Alexandra Weil, Karina C Furlan, Emily Poon, Murad Alam
Importance: Patients undergoing skin surgery under local anesthesia can experience anxiety. Adjuvant intraoperative anxiety reduction methods may help. Objectives: To assess whether hand-holding or holding a stress ball reduces patient anxiety during excisional surgery of head or neck skin cancer with the patient under local anesthesia and to measure pain and patient satisfaction. Design, Setting, and Participants: In this nonblinded, single-center randomized clinical trial, performed from January 24 through April 26, 2017, at a dermatology outpatient service in an urban, academic medical center, a consecutive sample of 135 adults who required excisional removal of nonmelanoma skin cancer of the head or neck was randomized and studied...
September 1, 2018: JAMA Dermatology
Maria Daniela Hurtado, Tiffany Cortes, Neena Natt, William F Young, Irina Bancos
OBJECTIVE: To identify predictors of hypothalamic-pituitary-adrenal (HPA) axis recovery interval and severity of glucocorticoid withdrawal symptoms (GWS) in patients undergoing adrenalectomy for corticotropin-independent cortisol excess. DESIGN: This is a retrospective study of patients with mild autonomous cortisol excess (MACE), moderate and severe Cushing syndrome (CS) who developed adrenal insufficiency after unilateral adrenalectomy between 1998 and 2017. RESULTS: Adrenalectomy was performed in 81 patients (79% women, median age 52 years [IQR 42-62])...
December 2018: Clinical Endocrinology
A Shudo, H Kishimoto, K Takaoka, K Noguchi
Tooth extraction in patients receiving bisphosphonates is thought to be a risk factor for osteonecrosis of the jaw (ONJ); however, ONJ did not develop, even when tooth extraction was performed with continued oral bisphosphonate therapy. A drug holiday from bisphosphonates before tooth extraction may not be necessary. INTRODUCTION: It is controversial whether bisphosphonate withdrawal is necessary prior to invasive procedures such as tooth extraction in order to prevent bisphosphonate-related osteonecrosis of the jaw (BRONJ)...
October 2018: Osteoporosis International
Elina Tiippana, Kaisa Nelskylä, Eija Nilsson, Eero Sihvo, Matti Kataja, Eija Kalso
Background and aims Thoracotomies can cause severe pain, which persists in 21-67% of patients. We investigated whether NSAID + intravenous patient-controlled analgesia (IV-PCA) with morphine is an efficacious alternative to thoracic epidural analgesia (TEA). We also wanted to find out whether an extended controlled pain management protocol within a clinical study can decrease the incidence of persistent post-thoracotomy pain. Methods Thirty thoracotomy patients were randomized into 3 intervention groups with 10 patients in each...
October 1, 2014: Scandinavian Journal of Pain
Brian M Ilfeld, Rodney A Gabriel, Engy T Said, Amanda M Monahan, Jacklynn F Sztain, Wendy B Abramson, Bahareh Khatibi, John J Finneran, Pia T Jaeger, Alexandra K Schwartz, Sonya S Ahmed
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain the day following knee surgery. However, it remains unknown if this analgesic technique may be used in ambulatory subjects following foot procedures beginning within the recovery room immediately following surgery, and with only short series of patients reported to date, the only available data are derived from strictly observational studies...
August 2018: Regional Anesthesia and Pain Medicine
Eric J Arias, Brent Bruck, Ananth K Vellimana, Charles Eby, Matthew R Reynolds, Morey A Blinder, Gregory J Zipfel
BACKGROUND AND IMPORTANCE: Antiphospholipid syndrome (APS) is an autoimmune disorder associated with a hypercoagulable state and increased risk of intraoperative and postoperative thrombosis. Few neurosurgical studies have examined the management of these patients, though the standard of care in most other disciplines involves the use of anticoagulation therapy. However, this is associated with risks such as hemorrhage, thrombosis due to warfarin withdrawal, and is not compatible with operative intervention...
May 24, 2018: Operative Neurosurgery (Hagerstown, Md.)
Min Wu, Jianzhong Guan, Yuzhou Xiao, Zhaodong Wang, Xiaotian Chen, Zhi Zhao, Kuankuan Zhang, Jun Zhu
Objective: To evaluate the effectiveness of three-dimensional (3-D) printing assisting minimally invasive for intraarticular calcaneal fractures with percutaneous poking reduction and cannulate screw fixation. Methods: A retrospective analysis was performed of the 19 patients (19 feet) with intraarticular calcaneal fracture who had been treated between March 2015 and May 2016. There were 13 males and 6 females with an average age of 38.2 years (range, 24-73 years)...
November 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Justin T Van Backer, Matthew R Jordan, Danielle T Leahy, Jesse S Moore, Peter Callas, Timothy Dominick, Peter A Cataldo
BACKGROUND: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied...
July 2018: Diseases of the Colon and Rectum
Cassie Brode, Megan Ratcliff, Jennifer Reiter-Purtill, Sanita Hunsaker, Michael Helmrath, Meg Zeller
BACKGROUND: Factors contributing to adolescents' non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery. OBJECTIVES: The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery ("completers") or withdrew from treatment ("non-completers")...
September 2018: Obesity Surgery
Pallav Mahesh Patni, Pradeep Jain, Sumeet Jain, Hemalatha Hiremath, Rolly Agarwal, Mona Jain Patni
Treating pathological defects that are caused by resorption in teeth can be challenging. The task is complicated further if the resorption extends beyond the restrains of the root. The aim of this report is to describe a case of extensive internal tunneling resorption (ITR) associated with invasive cervical resorption (ICR) in a maxillary right lateral incisor and its nonsurgical treatment. A 22-year-old male was referred to the department of endodontics with a chief complaint of discolored maxillary right lateral incisor or tooth 12 and a history of trauma...
January 2018: Journal of Conservative Dentistry: JCD
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