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Pain and treatment and elderly

Ji Li, Yabin Zou, Bin Wang, Xiangwei Meng, Xun Sun
RATIONALE: Primary renal lymphoma (PRL) is a rare malignancy due to the absence of lymphatic tissues in the kidney, and patients with PRL have been reported to have a poor prognosis due to its rapid invasiveness and limited treatment strategies. Colon cancer is the third most common cancer, and has a high mortality rate. Both malignant diseases predominantly affected elderly men; however, a case with concomitant occurrence of the 2 cancers is extremely rare. PATIENT CONCERNS: A 78-year-old male patient with abdominal pain came to our hospital...
March 2019: Medicine (Baltimore)
Jon O Wright, Anthony Ho, Jeremy Kalma, Denise Koueiter, Jason Esterle, David Marcantonio, J Michael Wiater, Brett Wiater
OBJECTIVES: To determine if uncemented implants would provide similar outcomes while avoiding the complications associated with cement in the treatment of elderly patients with proximal humerus fractures (PHFs) with primary reverse total shoulder arthroplasty (RTSA). DESIGN: Case series SETTING:: A single Level I trauma centerPatients/Participants: A prospectively-obtained cohort of 30 patients who underwent uncemented RTSA as initial treatment for a comminuted PHF: 4 male, 26 female; average age 71 ± 11 years...
February 26, 2019: Journal of Orthopaedic Trauma
Marcello Marchetti, Valentina Pinzi, Elena De Martin, Francesco Ghielmetti, Laura Fariselli
The trigeminal neuralgia (TN) is a chronic, episodic, and disabling facial pain syndrome. It is a relatively rare disorder. Despite this, because of the intensity of the pain, TN may have a dramatic impact for many patients. Fortunately, most of the patients may obtain a good pain relief simply by taking drugs. Historically, the surgical approaches represent a true treatment paradigm for all the drug-resistant TN. In this context, radiosurgery (RS) is a relatively new treatment modality. The effectiveness and safety of radiosurgery are today widely accepted and the technique can be proposed to many patients which suffer from a drug-resistant TN...
March 6, 2019: Neurological Sciences
Q Liu, J Cao, J J Kong
Objective: This study aims to discuss the clinical effect of balloon kyphoplasty on elderly patients with multiple osteoporotic vertebral fractures. Methods: The observation group was treated with balloon kyphoplasty, and the control group was managed with conservative treatment. Image indices, pain degree, daily life disturbance, and occurrences of complications were compared between the two groups. Results: In total, 116 elderly patients with multiple osteoporotic vertebral fracture admitted in our hospital from January 2016 to June 2017 were chosen and divided randomly into observation (n = 58) and control groups (n = 58)...
March 2019: Nigerian Journal of Clinical Practice
Justice O Agyei, David E Smolar, Joelle Hartke, Andrew A Fanous, Kevin J Gibbons
BACKGROUND: Botulinum toxin (Botox) has long been used therapeutically to treat a variety of diseases, including migraine headaches, cervical spine dystonia, and chronic cervical spine pain, among many others. Although quite useful, Botox has been reported to cause adverse events, some of which may lead to devastating morbidity. CASE DESCRIPTION: We discuss the case of an elderly woman who had severe neck pain after a motor vehicle collision. She underwent Botox administration to the neck extensor muscles after which she develop severe cervical kyphotic deformity, a complication only previously reported in patients with a history of cervical fusion...
February 26, 2019: World Neurosurgery
S H Lee, S S Han, B M Yoo, J W Kim
AIMS: The aim of this study was to evaluate the clinical and radiological outcomes of locking plate fixation, with and without an associated fibular strut allograft, for the treatment of displaced proximal humeral fractures in elderly osteoporotic patients. PATIENTS AND METHODS: We undertook a retrospective comparison of two methods of fixation, using a locking plate without an associated fibular strut allograft (LP group) and with a fibular allograft (FA group) for the treatment of these fractures...
March 2019: Bone & Joint Journal
Jian Zhang, Qiang Huang
OBJECTIVE: To investigate clinical results of reverse total shoulder arthroplasty in treating comminuted fracture of proximal humerus in elderly patients with rotator cuff injury. METHODS: From January 2017 to December 12, 12 comminuted fracture or dislocation of proximal humerus elderly patients were diagnosed as rotator cuff injury by preoperative MRI and operative exploration, and treated by reverse total shoulder arthroplasty. Among them, including 7 males and 5 females aged from 65 to 86 years old; 5 patients injured on the left side and 7 patients injured on the right side...
January 25, 2019: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Vincenzo Davide Palumbo, Benedetto Di Trapani, Antonio Bruno, Mario Feo, Bernardo Molinelli, Simone Tomasini, Attilio Ignazio Lo Monte, Marianna Messina, Giovanni Tomasello
INTRODUCTION: Hepatic abscess can be defined as an encapsulated collection of suppurative material within the liver parenchyma. Hepatic abscess can be distinguished as pyogenic, amebic, or fungal. Biliary tract disease remains the most common cause of hepatic abscess today, and the most common complications range from pleural effusion, empyema, and bronchohepatic fistula to subphrenic abscess and rupture into the peritoneal cavity, stomach, colon, vena cava, or kidney. A large abscess compressing the inferior vena cava and the hepatic veins may result in Budd-Chiari syndrome...
February 25, 2019: Journal of Medical Case Reports
Rene Przkora, Michael P Kinsky, Steve R Fisher, Christopher Babl, Christoph E Heyde, Terrie Vasilopoulos, Alan D Kaye, Elena Volpi
PURPOSE OF REVIEW: The treatment of debilitating pain and loss of function secondary to lumbar stenosis is in high demand with the aging patient population. Options, including epidural steroid injections (ESIs) and medication therapy, are limited and it is unclear if they provide any functional improvements. In this prospective study, we evaluate functional outcomes in older adults with symptomatic lumbar stenosis treated with ESIs compared to those managed with medications by introducing the Short Physical Performance Battery (SPPB)...
February 22, 2019: Current Pain and Headache Reports
Ping He, Ying Hu, Changwei Li, Dongmei Wu, Song Ge, Tingting Liu
BACKGROUND AND PURPOSE: Although mounting evidence has consistently shown that depressive symptoms are more common among diabetic women than among diabetic men, diabetic men are frequently overlooked in diabetes-related mental health studies, and research on predicators of depressive symptoms among diabetic men remains scarce. Therefore, the purpose of this study was to examine the gender-specific characteristics that predict depressive symptoms among mid-aged and elderly men with diabetes...
February 1, 2019: Research and Theory for Nursing Practice
Cassiopia L Lippold, Sachin P Kalarn, Ramya N Swamy, Ami M Patel
It has been shown that patients with end-stage renal disease (ESRD) have an increased risk for changes in intraocular pressure during hemodialysis, or ocular dialysis disequilibrium which can cause pain or discomfort during treatment and lead to decreased vision over time. This is a case of an elderly male with ESRD who was having headaches, nausea, and eye pain during hemodialysis due to increased intraocular pressures. Using a higher sodium prescription resolved his symptoms and normalized his intraocular pressures...
February 20, 2019: Hemodialysis International
Diego Filipe Bezerra Silva, Hellen Bandeira de Pontes Santos, Jorge Esquiche León, Daliana Queiroga de Castro Gomes, Pollianna Muniz Alves, Cassiano Francisco Weege Nonaka
Spindle cell squamous cell carcinoma of the tongue is a rare variant of squamous cell carcinoma. This paper reports the case of a spindle cell squamous cell carcinoma of the tongue, in a 64-year-old male patient, and presents a review of the etiopathogenesis, clinicopathological and immunohistochemical features and treatment of the malignancy. The patient presented for evaluation of a painful swelling on his tongue. Extraoral examination revealed palpable submandibular and superior cervical lymph nodes. Based on the presumptive diagnoses of squamous cell carcinoma or malignant salivary gland neoplasm, an incisional biopsy was performed...
February 18, 2019: Einstein
Laetitia Teixeira, Lia Araújo, Natália Duarte, Oscar Ribeiro
BACKGROUND: To explore the recent history of falls and the existence of fear of falling in a sample of centenarians, and to identify factors associated with both conditions. METHODS: The sample included 109 centenarians from two Portuguese studies. The two main outcomes of this study are fear of falling and history of fall(s). RESULTS: Results revealed that more than a half (51.4%) of the participants had fallen in the last 5 years and that the percentage of fear of falling was 78...
February 19, 2019: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Jae-Uk Sul, Myung Kwan Kim, Jungtae Leem, Hee-Geun Jo, Sang-Hoon Yoon, Jeeyong Kim, Eun-Jung Lee, Jeong-Eun Yoo, So Jung Park, Young Il Kim, Eunseok Kim, In Chul Jung, Ju-Hyun Jeon, Yang-Chun Park
BACKGROUND: Degenerative knee osteoarthritis is a leading cause of disability in the elderly. If patients do not respond to pharmacological or nonpharmacological intervention, total knee replacement surgery is recommended. However, owing to the contraindications and adverse effects of surgery, the need for a new treatment strategy is emerging. Traditional herbal medicine is a widely used intervention in east Asia to treat knee osteoarthritis. Gyejigachulbutang is one of the frequently prescribed herbal formulae...
February 19, 2019: Trials
Patrick Mcelaney, Masayuki Iyanaga, Stormy Monks, Edward Michelson
Tetanus is an increasingly rare diagnosis in the post-vaccination era, although it continues to have significant morbidity and mortality worldwide. In the United States (U.S.), the incidence of tetanus has declined dramatically due to the widespread use of the vaccine. High-risk populations for tetanus in the U.S. include the elderly, diabetics, injection drug users, and unvaccinated individuals. This is a report of a 78-year-old male with an incomplete immunization history who presented to an emergency department with jaw pain and who was ultimately diagnosed with tetanus...
February 2019: Clinical Practice and Cases in Emergency Medicine
David Ball, G Tao Mai, Shalini Vinod, Scott Babington, Jeremy Ruben, Tomas Kron, Brent Chesson, Alan Herschtal, Marijana Vanevski, Angela Rezo, Christine Elder, Marketa Skala, Andrew Wirth, Greg Wheeler, Adeline Lim, Mark Shaw, Penelope Schofield, Louis Irving, Benjamin Solomon
BACKGROUND: Stereotactic ablative body radiotherapy (SABR) is widely used to treat inoperable stage 1 non-small-cell lung cancer (NSCLC), despite the absence of prospective evidence that this type of treatment improves local control or prolongs overall survival compared with standard radiotherapy. We aimed to compare the two treatment techniques. METHODS: We did this multicentre, phase 3, randomised, controlled trial in 11 hospitals in Australia and three hospitals in New Zealand...
February 12, 2019: Lancet Oncology
Yong Ahn, Han Joong Keum, Sang-Gu Lee, Sheen-Woo Lee
OBJECTIVE: The clinical application of endoscopic technique for lumbar lateral recess stenosis (LRS) is still challenging. This study aimed to describe a transforaminal endoscopic decompression (TED) technique for LRS and to demonstrate its clinical results. METHODS: Two-year follow-up data were collected from 45 consecutive patients who underwent TED for LRS. Full-scale endoscopic decompression can be performed in the dorsal and ventral aspects of the lateral recess with combined partial pediculectomy using an articulating bone burr and endoscopic instruments...
February 11, 2019: World Neurosurgery
Yen-Feng Lai, Pei-Chao Lin, Chung-Hwan Chen, Jyu-Lin Chen, Hsin-Tien Hsu
Knee osteoarthritis (OA) is a very common disease in the elderly, and total knee replacement (TKR) surgery is currently considered the most effective treatment. A prospective, observational, repeated measures study was performed to explore the current status and changes in pain and activities of daily living (ADL) in 58 OA elderly patients undergoing unilateral TKR. The Wong⁻Baker Faces Pain Rating Scale (WBS) for pain and the self-reported Barthel Index for ADL were measured on the day before surgery, 48 hours after surgery, and the day before discharge...
February 8, 2019: Journal of Clinical Medicine
Alison M Thomas, Daniel K Fahim
BACKGROUND: Kyphoplasty is commonly employed in the treatment of compression fractures in the elderly and is increasingly utilized in the treatment of adult trauma along with concomitant instrumentation. Although kyphoplasty with instrumentation has been reported in pediatric patients, concerns regarding retardation of spinal growth and iatrogenic spinal deformity have been raised. The utilization of kyphoplasty without instrumentation has yet to be reported in the case of pediatric patients...
February 7, 2019: World Neurosurgery
Trang T H Tu, Miho Takenoshita, Hirofumi Matsuoka, Takeshi Watanabe, Takayuki Suga, Yuma Aota, Yoshihiro Abiko, Akira Toyofuku
Burning Mouth Syndrome (BMS), a chronic intraoral burning sensation or dysesthesia without clinically evident causes, is one of the most common medically unexplained oral symptoms/syndromes. Even though the clinical features of BMS have been astonishingly common and consistent throughout the world for hundreds of years, BMS remains an enigma and has evolved to more intractable condition. In fact, there is a large and growing number of elderly BMS patients for whom the disease is accompanied by systemic diseases, in addition to aging physical change, which makes the diagnosis and treatment of BMS more difficult...
2019: BioPsychoSocial Medicine
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