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An evaluation of ketoprofen as an intranasal anti-inflammatory agent.

The objective of the study was to evaluate the effect of ketoprofen when locally applied to tissue-cultured nasal epithelium.

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Revisiting Lunotriquetral Arthrodesis in Chronic Lunotriquetral Ligamentous Injuries.

 Chronic lunotriquetral (LT) ligament tears are a source of ulnar-sided wrist pain. Left untreated, complete tears of the LT ligament may progress to a volar intercalated segment instability deformity and eventual carpal arthritis. Various treatments have been proposed, one of which is LT arthrodesis. LT arthrodesis has been criticized for high rates of nonunion frequently requiring reoperation, and therefore has largely fallen out of favor. However, our experience has been quite different from the literature. This study examines a single surgeon's experience with LT arthrodesis over a 15-year period.  A retrospective review of the senior author's practice over a 15-year period was performed. All adult cases of LT arthrodesis for chronic LT injuries were included. Headless compression screw and cancellous bone graft from the distal radius were used for primary arthrodesis in all cases. The primary outcome was rate of union, and secondary outcomes were time to union, secondary or salvage procedures, and range of motion. Nonparametric statistical analysis was used to calculate differences in outcomes.  Twenty-eight patients met inclusion criteria. The median age was 45.5 (interquartile range [IQR] 35-50) years and 75% were male. The dominant hand was most commonly affected. Eighty-six percent of patients achieved union, one patient required redo arthrodesis, and one patient went on to wrist salvage. Three patients developed a pain-free pseudoarthrosis. Median time to radiographic union was 8.8 (IQR 5.9-11.9) weeks.  Despite multiple previous reports, this study demonstrates that LT arthrodesis for chronic LT injuries is a safe technique with high rates of successful union. Further comparative studies are warranted to determine the optimal treatment for chronic LT injuries.

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Takayasu Arteritis with Isolated Headache and Neck Pain.

Takayasu Arteritis (TA), a chronic inflammatory condition of the aorta and its major branches, causes narrowing and ultimate occlusion of major vessels and may manifest as cerebrovascular insufficiency, organ ischemia, and systemic arterial hypertension (HTN). Herein, we report a case of a 35-year female with the pulseless disease but no other clinical signs except headache and neck pain on exertion despite the fact that three out of four vessels of the aortic arch were occluded. Diagnosis of TA was based on clinical findings, radiological imaging, and doppler studies. This case report highlights the clinical importance of unexplained headaches and absent peripheral pulses in the screening of TA. Key Words: Takayasu arteritis, Unexplained headache, Neck pain.

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Educating and engaging a new target audience about the problem of pain for society.

Pain education initiatives are typically targeted at health professionals, with less attention being placed on the education of other target audiences. Recent curriculum changes across undergraduate liberal studies degree programs at The University of Sydney presented an opportunity to develop an online course entitled Health Challenges: Pain and Society, which was aimed at a non-traditional target audience. To promote student engagement about the problem of pain for society, the course was designed using the Community of Inquiry framework. This paper reports on an Educational Design Research study, investigating the effectiveness of the course in engaging students across two cohorts, in 2019 and 2020. Learning analytics were collected from the Learning Management System each year. The level of student engagement in non-assessable tasks was measured using multiple linear regression. Students' degree type and majors were recorded. In 2020, the quality of student workbook responses was recorded. In both cohorts, engagement with the workbooks was a predictor of academic achievement. In 2020, a significant interaction effect between quantity and quality of engagement was observed. Our findings highlight the importance of designing online learning to facilitate successful engagement for non-traditional target audiences about the issue of chronic pain for society.

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Radiofrequency techniques for chronic pain.

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Anesthesia and Analgesia for the Obese Parturient.

Obesity is a worldwide epidemic and is associated with an increased risk of hypertension, diabetes, and obstructive sleep apnea. Pregnant patients with obesity experience a higher risk of maternal and fetal complications. Anesthesia also poses higher risks for obese parturients and may be more technically challenging due to body habitus. Safe anesthesia practice for these patients must take into consideration the unique challenges associated with the combination of pregnancy and obesity.

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Acute COVID-19 Infection in a Pediatric Patient with ROHHAD.

The novel coronavirus (severe acute respiratory syndrome coronavirus-2) has led to a global pandemic. In the adult population, coronavirus disease 2019 (COVID-19) has been found to cause multiorgan system damage with predicted long-term sequelae. We present a case of a 10-year-old boy with a history of ROHHAD (rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation) who presented with hypoxia, emesis, and abdominal pain. Imaging found bilateral ground glass opacities in the lungs and a pericardial effusion. Laboratory evaluation was concerning for elevated inflammatory markers. Remdesivir, hydroxychloroquine, and anticoagulation (heparin and enoxaparin) were utilized. The patient's severe respiratory failure was managed with conventional mechanical ventilation, inhaled nitric oxide, and airway pressure release ventilation. We hope that this report provides insight into the course and management of the severe acute pediatric COVID-19 patient, specifically with underlying comorbidities such as ROHHAD. Clinical trial registration is none.

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Impact of video-assisted thoracoscopic lobectomy versus open lobectomy for lung cancer on recovery assessed using self-reported physical function: VIOLET RCT.

Lung cancer is the leading cause of cancer death. Surgery remains the main method of managing early-stage disease. Minimal-access video-assisted thoracoscopic surgery results in less tissue trauma than open surgery; however, it is not known if it improves patient outcomes.

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Effect of Preexisting Sarcopenia on Acute and Late Postoperative Pneumonia Among Patients With Oral Cavity Squamous Cell Carcinoma.

Whether preexisting sarcopenia is an independent risk factor for postoperative pneumonia (POP) for patients with oral cavity squamous cell carcinoma (OCSCC) remains unclear. Therefore, we conducted a propensity score-matched population-based cohort study to compare the risk of acute and late POP for patients with sarcopenic and nonsarcopenic OCSCC who underwent curative surgery.

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The Correlation of PANSS Scores and P100 Latency in Patients with Schizophrenia and Migrene Hedache Using Visual Evoked Potentials (VEPS) According to Gender and Age.

The VEPs provide an objective measure of brain function, analyzing integrity of visual processing. With patients affected with schizophrenia, the changes with the implementation of VEP are evident, such as symmetrical deceleration of the impulse and the continuance of latency, which points to a degenerative illness, suggesting the presence of optical neuritis or hemianopsia conjoined with mentioned intracranial illness.

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