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Using a Narrative Practice Approach to Understand In-Depth Experiences of Individuals Coping with Chronic Pain.

Current psychological interventions to enhance management of chronic pain report small to moderate effects. There is a need to explore the experiences and coping of individuals with chronic pain in depth and expand beyond current knowledge paradigms to enhance psychological interventions. The current literature recommends narrative practice as a qualitative approach in a group to facilitate sharing of knowledge on coping with chronic pain. Therefore, we conducted group sessions incorporating narrative practice to explore the experiences of individuals coping with chronic pain.

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Abnormal Anatomical and Radiological Changes in a Rare Presentation of Adult Developmental Dysplasia of the Hip.

Adult presentation of bilateral dysplasia and dislocation is an extremely rare presentation. The management of adult hip dysplasia is to preserve the hip and reduce pain through surgical intervention. Hence, early diagnosis provides more options as the treatment dilemma with the late presentation is very complicated with debatable prognosis. The case presented is a 53-year old woman who complained of persistent pain in the hip region. On radiology, dysplasia and dislocation of both the hip joints were observed along with soft tissue abnormalities around the joint. In this case report, we discuss the underlying pathophysiology that might have led to the abnormal radiological and anatomical changes in the hip region and the possible treatment options in a conservatively managed case of developmental dysplasia of the hip (DDH).

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Conservative Treatments Frequently Used for Chronic Pain Patients in Clinical Practice: A Literature Review.

Chronic pain is a common patient complaint in clinical practice. It results in the deterioration of patients' quality of life and loss of productivity. Also, it often brings about psychiatric disorders such as depression and anxiety. Therefore, clinicians should manage chronic pain actively. Various conservative treatments, including pharmacological therapy, procedures, and exercise, are being used to control chronic pain. In this review article, I provide an overview of the commonly used treatments, including medication [anticonvulsants, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, antidepressants], procedures [injection of steroids and local anesthetics, pulsed radiofrequency (PRF), repetitive transcranial magnetic stimulation (rTMS), prolotherapy], and exercise. A brief overview of these treatments would allow clinicians to have an overall picture of the available tools for managing chronic pain in clinical practice at a glance.

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Experience of trans-nasal endoscopic surgery for pituitary tumors in a single center in China: Surgical results in a cohort of 2032 patients, operated between 2006 and 2018.

This study was conducted to investigate complications and outcome by endonasal endoscopic approach in our single center.

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Preoperative Duloxetine to improve acute pain and quality of recovery in patients undergoing modified radical mastectomy: A dose-ranging randomized controlled trial.

Duloxetine has been recently used as a part of multimodal analgesia in perioperative settings, yet the optimal dose of Duloxetine is not determined.

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Management of Eosinophilic Esophagitis: Dietary and Nondietary Approaches.

Eosinophilic esophagitis (EoE) is an allergen-driven chronic inflammatory condition, characterized by symptoms related to esophageal dysfunction and confirmed histologically by esophageal mucosal eosinophilia. Since its first description in the 1990s, the incidence and prevalence of EoE have been on the rise. It is known to affect all ages of various ethnic backgrounds and both sexes; however, it is most seen in White males. Children with EoE often present with abdominal pain, nausea, vomiting, and failure to thrive, whereas adults with EoE typically present with dysphagia and food impaction. Diagnosis of EoE requires histologic confirmation of elevated esophageal eosinophils in a symptomatic patient, and only after secondary causes have been excluded. Because EoE is a chronic and progressively fibrostenotic disease, treatment goals include resolution of symptoms, induction and maintenance of disease remission, and prevention and possibly reversal of fibrostenotic complications, while minimizing treatment-related adverse effects and improving quality of life. Treatment strategies include the "3 D's"-drugs, diet, and dilation. Standard drug therapies include proton-pump inhibitors and topical corticosteroids. Dietary therapies include elemental diet, allergy testing-directed elimination diet, and empiric elimination diets. Endoscopic esophageal dilation for EoE strictures can alleviate esophageal symptoms but has no effect on mucosal inflammation. Recent progress in EoE research has made possible evidence-based clinical guidelines. Ongoing pharmacologic trials show promise for novel biologic agents in the treatment of refractory EoE.

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Relationship between dexamethasone added to periarticular anesthetic infiltration and postoperative nausea and vomiting following total knee arthroplasty under general anesthesia: a retrospective observational study.

Periarticular anesthetic infiltration (PAI) with a corticosteroid is a modality for pain control following total knee arthroplasty (TKA). Systemic corticosteroids are an established antiemetic for the prophylaxis of postoperative nausea and vomiting (PONV). The purpose of this retrospective observational study was to elucidate the relationship between dexamethasone added to PAI and PONV in patients who underwent TKA.

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Pain Syndromes Secondary to Cluneal Nerve Entrapment.

The purpose of this review is to provide an overview of the cluneal nerves, present a summary of pain syndromes secondary to clunealgia, and evaluate current literature for diagnostic and treatment modalities.

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Paramedic Pain Management Practice with Introduction of a Non-opiate Treatment Protocol.

There is concern about the initiation of opiates in healthcare settings due to the risk of future misuse. Although opiate medications have historically been at the core of prehospital pain management, several states are introducing non-opiate alternatives to prehospital care. Prior studies suggest that non-opiate analgesics are non-inferior to opiates for many acute complaints, yet there is little literature describing practice patterns of pain management in prehospital care. Our goal was to describe the practice patterns and attitudes of paramedics toward pain management after the introduction of non-opiates to a statewide protocol.

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Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19: A Randomized Clinical Trial.

Remdesivir demonstrated clinical benefit in a placebo-controlled trial in patients with severe coronavirus disease 2019 (COVID-19), but its effect in patients with moderate disease is unknown.

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