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Yoga Practice Among Veterans With and Without Chronic Pain: A Mixed Methods Study.

The primary aim of this study was to examine differences in yoga practice between persons with and without chronic pain. Secondarily, we describe use of the Essential Properties of Yoga Questionnaire, Short Form (EPYQ-SF) for self-report.

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Treatment of acute pancreatitis with pancreatic duct decompression via ERCP: A case report series.

Acute pancreatitis is a common disorder in the gastrointestinal system, which is characterized by an increasing incidence and a high mortality. Currently, symptomatic treatment becomes the predominant option for the treatment of acute pancreatitis. To date, there is little knowledge on the treatment of acute pancreatitis through alleviation of pancreatic ductal hypertension and removal of pancreatic ductal obstruction. Endoscopic retrograde cholangiopancreatography (ERCP), an effective treatment for acute biliary pancreatitis, may alleviate the obstruction and edema in the common channel of the bile duct and pancreatic duct, to achieve the indirect treatment of acute pancreatitis, and may achieve the removal of intrapancreatic ductal obstruction and reduction in the intrapancreatic ductal pressure. Hereby, we report 3 cases with acute pancreatitis that were successfully treated by the pancreatic duct decompression via ERCP in one single center from China. Our data demonstrate that pancreatic duct decompression via ERCP is effective for the treatment of acute pancreatitis, which may shorten the course of acute pancreatitis through alleviating pain, shortening fasting duration and controlling the inflammatory reactions. It is recommended to use further prospective, randomized, controlled clinical trials to evaluate the efficacy and safety of pancreatic duct decompression via ERCP for acute pancreatitis.

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Neuraxial Labor Analgesia Utilization, Incidence of Postdural Puncture Headache, and Epidural Blood Patch Placement for Privately Insured Parturients in the United States (2008-2015).

Neuraxial analgesia is the gold standard for labor analgesia in the United States, and postdural puncture headache (PDPH) is one of the most common complications. PDPH is frequently treated with an epidural blood patch (EBP), but conservative treatment approaches remain common. Our current understanding of the incidence of PDPH and the frequency of EBP utilization is heavily based on reports from academic medical centers. We studied a private insurance database to provide estimates of neuraxial labor analgesia (NLA) use and PDPH and EBP incidence in the United States.

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Persistent orofacial pain associated with nasopharyngeal extramedullary plasmacytoma.

Orofacial pain (OFP) disorders affect the maxillofacial complex and typically involve other locations in the head and neck. Common etiologies of OFP disorders include odontogenic sources, temporomandibular disorders, neuropathic pain, chemosensory disorders, and headaches. Less commonly, benign and malignant neoplasms can be associated with OFP complaints. Patients with OFP symptoms require a thorough evaluation and are often referred to additional healthcare providers for interprofessional management. In those OFP patients whose symptoms do not respond to conventional treatment(s), whose symptoms change over time, or who report positive responses to review of systems questions that suggest more extensive involvement, further investigation is warranted. To the best of our knowledge, this is the first case report of nasopharyngeal extramedullary plasmacytoma, a localized malignant neoplasm, associated with persistent OFP.

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The role of acupuncture in the treatment of chronic pain.

Acupuncture is a practice based on traditional Chinese medicine, in which needles are used to restore the body's internal balance. Recently, there has been growing interest in the use of acupuncture for various pain conditions. Acupuncture's efficacy in five pain conditions-low back pain (LBP), migraines, fibromyalgia, neck pain, and abdominal pain-was evaluated in this evidence-based, comprehensive review. Based on the most recent evidence, migraine and fibromyalgia are two conditions with the most favorable outcomes after acupuncture. At the same time, abdominal pain has the least evidence for the use of acupuncture. Acupuncture is efficacious for reducing pain in patients with LBP, and for short-term pain relief for those with neck pain. Further research needs to be done to evaluate acupuncture's efficacy in these conditions, especially for abdominal pain, as many of the current studies have a risk of bias due to lack of blinding and small sample size.

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The Analgesic Efficacy of Pecto-Intercostal Fascial Block Combined with Pectoral Nerve Block in Modified Radical Mastectomy: A Prospective Randomized Trial.

Pectoral nerve (Pecs) block is one of the most promising regional analgesic techniques for breast surgery. However, Pecs II block may not provide analgesia of the medial aspect of the breast or the entire nipple-areolar complex.

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Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis (SAPHO): An Interesting Clinical Syndrome.

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare disorder that classically involves the musculoskeletal system, i.e. bone, joint and skin. The exact pathogenesis of this syndrome is unknown. However, autoimmunity, infections, immune malfunction and genetic factors are attributed to its pathophysiology. Bone and joint involvements are the hallmark of SAPHO syndrome and not necessarily require cutaneous involvement at the time of diagnosis. X-ray of the affected joints could show osteitis with sclerosis. Anterior chest wall involvement particularly ''bullhead appearance'' seen on bone scan is a striking feature of the syndrome. Erythrocyte sedimentation rate (ESR) is usually elevated amongst the majority of patients. Diagnosis of SAPHO is always challenging and often delayed because of a multitude of symptoms. The mainstay of treatment is control of pain and inflammation with both non-steroidal anti-inflammatory drugs (NSAIDs) and rescue courses of systemic steroids. If failed to control symptoms with first-line agents and in those with severe disease, disease-modifying anti-inflammatory drugs (DMARDs) may be needed eventually. Despite a chronic inflammatory condition, it remains stable in the majority of cases. Here in this case report, we reiterate the importance of early recognition, timely diagnosis and prompt treatment initiation.

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Complementary, Integrative, and Nondrug Therapy Use for Pain Among US Military Veterans on Long-term Opioids.

Long-term opioid therapy for chronic pain arose amid limited availability and awareness of other pain therapies. Although many complementary and integrative health (CIH) and nondrug therapies are effective for chronic pain, little is known about CIH/nondrug therapy use patterns among people prescribed opioid analgesics.

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Detection of chlorite, chlorate and perchlorate in ozonated saline.

Medical ozone is used to treat various diseases, including numerous pathologies associated with chronic pain. Chronic pain may be treated by systemic administration of ozone, with ozonated autohemotherapy (OAH) being the commonly used method. In the clinic, intravenous infusion of ozonized saline has been used to treat various diseases. Compared with OAH, ozonized saline infusion is less technically demanding and causes minimal damage to veins. However, it has been indicated that ozone may oxidize saline and generate toxic substances, and therefore, the safety of ozone treatment has been questioned. In the present study, the potential chemical compounds produced from ozone and saline, including chlorite, chlorate and perchlorate, were examined at various time-points with ion chromatography-mass spectrometry (IC-MS). A control group (pure oxygen group) and an ozone group were included in the present study. Two subgroups were included within each group: A saline bottle (made from polypropylene) subgroup and an ozone-resistant blood transfusion bag [made from medical polyvinyl chloride, di(2-ethyl) hexyl phthalate plasticized] subgroup. For the ozone group, 100 ml saline and 100 ml medical ozone at various concentrations (20, 40 or 60 µg/ml in pure oxygen) were injected into the saline bottle or blood bag, and for the control group, 100 ml of pure oxygen was injected into the saline bottle or blood bag. The presence and the content of chlorite, chlorate and perchlorate were determined at different time-points (3, 6 and 15 days after mixing) by IC-MS. Chlorate was detected in the ozone groups at three time-points and its content increased as the ozone concentration and the reaction time increased. Under the same conditions (the same ozone concentration and the same incubation time), the chlorate content (0.90±0.14-7.69±0.48 µg/l) in the blood bag subgroup was significantly lower than that in the saline bottle subgroup (45.23±6.14-207.6±15.63 µg/l). However, chlorite and perchlorate were not detected at any time-point in the two groups. In addition, in the control group (pure oxygen group), chlorite, chlorate and perchlorate were not detected at any time-point. These results indicate that ozone reacts with saline to produce chlorate. Ozone may also react with the polypropylene saline bottle to increase the chlorate content in the bottled solution. Due to a lack of toxicology studies of chlorate in blood, it remains elusive whether ozonated saline and chlorate at the range of 0.90±0.14-7.69±0.48 µg/l has any toxic effects. The potential toxicity of chlorate should be considered when ozonated saline is used for clinical infusions.

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Factors associated with non-active retinal capillary density as measured with Confocal Scanning Laser Doppler Flowmetry in an elderly population: the Thessaloniki Eye Study (TES).

To identify factors associated with retinal capillary density as measured with Confocal Scanning Laser Doppler Flowmetry (Heidelberg retina flowmeter (HRF)) in the Thessaloniki Eye Study (TES).

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