Nathan Balzer, Shelley McLeod, Chris Walsh, Keerat Grewal
OBJECTIVE: There has been increased interest in the use of low dose ketamine (LDK) as an alternative analgesic for the management of acute pain in the emergency department (ED). The objective of this systematic review was to compare the analgesic effectiveness and safety profile of LDK and morphine for acute pain management in the ED. METHODS: Electronic searches of Medline and EMBASE were conducted and reference lists were hand-searched. Randomized controlled trials (RCTs) comparing LDK to morphine for acute pain control in the ED were included...
October 24, 2020: Academic Emergency Medicine
Brian Fiani, Juliana Runnels, Ashley Taylor, Manraj Sekhon, Daniel Chacon, Michael McLarnon, Rebecca Houston, Sasha Vereecken
Spinal injury is among the most severe and feared injuries an athlete may face. We present an up-to-date review of the recent literature, stratifying recommendations based on injury location (cervical, thoracic, and lumbar spine) and type, as well as, the level of competitive play (high school, collegiate, professional). A literature search was completed to identify all publications reporting return to play guidelines for athletic injuries or injury-related surgery irrespective of the study design. Publication dates were not restricted by year...
October 26, 2020: Reviews in the Neurosciences
Christopher Bond, Justin Morgenstern, Corey Heitz, William K Milne
Epigastric pain and dyspepsia are common presenting complaints to the emergency department and are typically treated with a variety of antacids, antihistamines, proton pump inhibitors, or anticholinergics. Prior studies have shown mixed results for acute dyspepsia management, which raises the question as to the optimal analgesic therapy. This study compares antacid monotherapy with two combinations of lidocaine with antacid in the treatment of dyspepsia.
October 24, 2020: Academic Emergency Medicine
Q Z Ruan, W English, A Hotouras, C Bryant, F Taylor, S Andreani, S D Wexner, S Banerjee
BACKGROUND: Symptomatic haemorrhoids affect a large number of patients throughout the world. The aim of this systematic review was to compare the surgical outcomes of stapled haemorrhoidopexy (SH) versus open haemorrhoidectomy (OH) over a 20-year period. METHODS: Randomized controlled trials published between January 1998 and January 2019 were extracted from Pubmed using defined search criteria. Study characteristics and outcomes in the form of short-term and long-term complications of the two techniques were analyzed...
October 24, 2020: Techniques in Coloproctology
Stephan Leisengang, Franz Nürnberger, Daniela Ott, Jolanta Murgott, Rüdiger Gerstberger, Christoph Rummel, Joachim Roth
One maladaptive consequence of inflammatory stimulation of the afferent somatosensory system is the manifestation of inflammatory pain. We established and characterized a neuroglial primary culture of the rat superficial dorsal horn (SDH) of the spinal cord to test responses of this structure to neurochemical, somatosensory, or inflammatory stimulation. Primary cultures of the rat SDH consist of neurons (43%), oligodendrocytes (35%), astrocytes (13%), and microglial cells (9%). Neurons of the SDH responded to cooling (7%), heating (18%), glutamate (80%), substance P (43%), prostaglandin E2 (8%), and KCl (100%) with transient increases in the intracellular calcium [Ca2+ ]i ...
October 24, 2020: Pflügers Archiv: European Journal of Physiology
Kezia A Addo, Niharika Palakodety, Rebecca C Fry
Acetaminophen is the only medication recommended for pain and fever management during pregnancy. However, studies have reported an association between in utero acetaminophen and neurocognitive disorders later in life. Additionally, acetaminophen has been shown to have endocrine disrupting properties altering hormones critical for normal fetal development. As the placenta is an endocrine organ that produces hormones for fetal development, any attempts to elucidate the mechanism underlying in utero acetaminophen and birth outcomes must also focus on the placenta...
October 24, 2020: Toxicological Sciences: An Official Journal of the Society of Toxicology
Mahnaz Ashrafi, Nadia Jahangiri, S Hahideh Jahanian Sadatmahalleh, Fatemeh Aliani, Mohammad Reza Akhoond
Background: Endometriosis is one of the most common pelvic diseases associated with dyspareunia, pelvic pain, and infertility. The primary aim of this study is to evaluate the role of diet on the risk of endometriosis among Iranian women. Materials and Methods: This case-control study was conducted in two health research centres between 2015 and 2016. There were 207 women with endometriosis (case) and 206 women without endometriosis (control) who were evaluated by laparoscopy...
October 2020: International Journal of Fertility & Sterility
Paolo Mezzana
INTRODUCTION: Menopause is the condition when a woman no longer manifests menstrual periods. GSM (Genitourinary Syndrome) is the acronym to describe possible symptoms of this condition. Vaginal dryness can be a particular problem for women entering menopause, it can make the intercourse painful and may cause the increase in the need to urinate. Aim of this study is to evaluate the efficacy of combined fractional CO2 (10.500 nm) ablative and 1540 nm non-ablative lasers on these symptoms...
October 24, 2020: Dermatologic Therapy
Sylvie Le May, Argerie Tsimicalis, Melanie Noel, Pierre Rainville, Christelle Khadra, Ariane Ballard, Estelle Guingo, Casey Cotes-Turpin, Sofia Addab, Khadidja Chougui, Maxime Francoeur, Nicole Hung, Mitchell Bernstein, Stéphane Bouchard, Stefan Parent, Mathilde Hupin Debeurme
AIMS: To examine the efficacy of an immersive virtual reality distraction compared with an active non-immersive distraction, such as video games on a tablet, for pain and anxiety management and memory of pain and anxiety in children requiring percutaneous bone pins and/or suture removal procedures. DESIGN: Three-centre randomized clinical trial using a parallel design with two groups: experimental and control. METHODS: Study to take place in the orthopaedic department of three children hospital of the Montreal region starting in 2019...
October 24, 2020: Journal of Advanced Nursing
Chelsey Solar, Allison M Halat, R Ross MacLean, Haseena Rajeevan, David A Williams, Sarah L Krein, Alicia A Heapy, Matthew J Bair, Robert D Kerns, Diana M Higgins
Internet-based interventions for chronic pain have demonstrated efficacy and may address access barriers to care. Participant characteristics have been shown to affect engagement with these programs; however, limited information is available about the relationship between participant characteristics and engagement with internet-based programs for self-management of chronic pain. The current study examined relationships between demographic and clinical characteristics and engagement with the Pain EASE program, a self-directed, internet-based cognitive behavioral therapy intervention for veterans with chronic low back pain (cLBP)...
October 24, 2020: Translational Behavioral Medicine
Mark A Chmiela, Mark Hendrickson, Jason Hale, Chen Liang, Phillip Telefus, Afrin Sagir, Michael Stanton-Hicks
INTRODUCTION: Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD), is a difficult to treat condition characterized by debilitating pain and limitations in functional ability. Neuromodulation, in the form of spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS), have been traditionally used as a treatment for CRPS with variable success. OBJECTIVE: This chart review describes the use of implantable PNS systems in the treatment of CRPS of the upper and lower extremities spanning nearly three decades...
October 24, 2020: Neuromodulation: Journal of the International Neuromodulation Society
Ye Cao, Adrian Ujin Yap, Jie Lei, Min-Juan Zhang, Kai-Yuan Fu
OBJECTIVES: To determine the differences in psychological states and sleep quality in patients with various Temporomandibular disorder (TMD) subtypes, and to ascertain the relationships between TMD duration with psychological and sleep impairments. METHODS: A total of 830 TMD patients were recruited categorized into pain-related (PT), intra-articular (IT), and combined (CT) TMD groups. Each group was further divided into acute and chronic subtypes. The Depression, Anxiety, Stress Scales-21 (DASS-21), and Pittsburgh Sleep Quality Index (PSQI) were used to assess emotional states and sleep problems...
October 23, 2020: Oral Diseases
Katherine A J Daniels, Enda King, Chris Richter, Éanna Falvey, Andy Franklyn-Miller
Athletic groin pain (AGP) is a chronic, painful condition which is prevalent in players of field sports that require rapid changes of direction. Following successful rehabilitation, systematic changes have been observed in the kinetics and kinematics of pre-planned change of direction manoeuvres, providing insight into potential foci for rehabilitation monitoring and for the assessment of interventions. However, changing direction in field sports is often reactive rather than pre-planned, and it is not known whether such post-rehabilitation changes are seen in reactive manoeuvres...
October 23, 2020: Scandinavian Journal of Medicine & Science in Sports
Yuri M Costa, Beatrice P De Koninck, Sherif M Elsaraj, Fernando G Exposto, Alberto Herrero Babiloni, Flavia P Kapos, Sonia Sharma, Akiko Shimada
Dentists stand in an optimal position to prevent and manage patients suffering from chronic orofacial pain (OFP) disorders, such as temporomandibular disorders, burning mouth syndrome, trigeminal neuralgia, persistent idiopathic dentoalveolar pain, among others. However, there are consistent reports highlighting a lack of knowledge and confidence in diagnosing and treating OFP among dental students, recent graduates, and trained dentists, which leads to misdiagnosis, unnecessary costs, delay in appropriate care and possible harm to patients...
October 23, 2020: Journal of Dental Education
Jisun Jeong, Sun Woong Kim, Duk Hyun Sung
OBJECTIVES: Neurolymphomatosis (NL) is a disease characterized by the infiltration of malignant lymphocytes into the peripheral nervous system. We report clinical features, radiographic findings, modes of treatment, and outcomes of patients with NL. METHODS: We retrospectively investigated patients with NL. We extracted data, including clinical features, magnetic resolution imaging (MRI), 18 F-fludeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scans, cerebrospinal fluid cytology findings, the results of electrodiagnostic studies, as well as patient treatments and outcomes...
October 23, 2020: Journal of Neurology
Takeo Nakada, Suguru Shirai, Yuko Oya, Yusuke Takahashi, Noriaki Sakakura, Takashi Ohtsuka, Hiroaki Kuroda
BACKGROUND: We aimed to analyze the feasibility and risk factors associated with early mobilization (EM) within 4 h after thoracoscopic lobectomy and segmentectomy. METHODS: This study retrospectively evaluated 214 consecutive patients who underwent thoracoscopic anatomical pulmonary resection using our EM protocol between October 2017 and February 2019. We compared the correlations of the patients' characteristics including the total number of drugs and perioperative parameters such as air leak, and orthostatic hypotension (OH) between the EM (E group) and failed EM (F group) groups...
October 23, 2020: World Journal of Surgery
Alan David Kaye, Cassandra Armstead-Williams, Farees Hyatali, Katherine S Cox, Rachel J Kaye, Lauren K Eng, Muhammad A Farooq Anwar, Perene V Patel, Shilpa Patil, Elyse M Cornett
PURPOSE OF REVIEW: Multimodal pain management is the most effective way to treat postsurgical pain. However, the use of opioids for acute pain management has unfortunately been a significant contributor to the current opioid epidemic. The use of opioids should be limited and only considered a "rescue" pain medication after other modalities of pain management have been utilized. RECENT FINDINGS: It may be difficult to curtail the use of opioids in the treatment of chronic pain; however, in the postsurgical setting, there is compelling evidence that an opioid-centric analgesic approach is not necessary for good patient outcomes and healthcare cost benefits...
October 23, 2020: Current Pain and Headache Reports
Yeşim Kaya, Özer Alkan, Ahmet Ufuk Kömüroglu, Sıddık Keskin
OBJECTIVE: The goal of this study was to compare the effects of ibuprofen and low-level laser therapy in alleviating orthodontic pain observed after elastomeric separator placement (ESP) by means of the analysis of interleukin 1‑beta (IL-1β) and substance P (SP) levels in gingival crevicular fluid (GCF) and visual analog scale (VAS). MATERIALS AND METHODS: A total of 60 subjects requiring ESP for the banding of maxillary first molars were randomly assigned to the ibuprofen, laser, and control groups...
October 23, 2020: Journal of Orofacial Orthopedics
Thomas A Perry, Xiaotian Yang, James van Santen, Nigel K Arden, Stefan Kluzek
OBJECTIVES: Synovitis in symptomatic knee OA (KOA) is common and is associated with joint symptoms. Optimal synovial measurement on MRI is, however, unclear. Our aims were to examine the relationship between MRI measures of synovitis and knee symptoms in symptomatic KOA. METHODS: Data from a randomized, multicentre, placebo-controlled trial (UK-VIDEO) of vitamin-D therapy in symptomatic KOA were utilized. Participants reported knee symptoms using WOMAC at baseline and annually...
October 23, 2020: Rheumatology
Ismael Rodríguez-Rodríguez, Joanna Kalafut, Arkadiusz Czerwonka, Adolfo Rivero-Müller
The cannabinoid receptor type 1 (CB1) plays critical roles in multiple physiological processes such as pain perception, brain development and body temperature regulation. Mutations on this gene (CNR1), results in altered functionality and/or biosynthesis such as reduced membrane expression, changes in mRNA stability or changes in downstream signaling that act as triggers for diseases such as obesity, Parkinson's, Huntington's, among others; thus, it is considered as a potential pharmacological target. To date, multiple quantification methods have been employed to determine how these mutations affect receptor expression and localization; however, they present serious disadvantages that may arise quantifying errors...
October 23, 2020: Scientific Reports
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