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The effects of botulinum toxin type A injection on pain symptoms, quality of life, and sleep quality of patients with diabetic neuropathy: A randomized double-blind clinical trial.

Neuropathic pain is one of the most common problems in patients with diabetes mellitus (DM). In this study, the effect of botulinum toxin type A (BTX-A) on neuropathic pain, quality of sleep, and quality of life of diabetic patients with sensorimotor polyneuropathy was studied. This randomized placebo-controlled trial study was carried out in a double-blind (patient-researcher) method. The study was performed on 32 patients with type 2 DM. Neuropathy was confirmed by Douleur Neuropathique 4 (DN4) Questionnaire and nerve conduction study (NCS). The patients were randomly assigned to two intervention and control groups based on the random numbers table. After selecting the subjects, we used 36-Item Short Form Health Survey (SF-36), Neuropathic Pain Scale (NPS), Visual Analogue Scale (VAS), and Pittsburgh Sleep Quality Index (PSQI) questionnaires before and after 3 months of 100 units BTX-A injection (as intervention group) or same amount of chloride sodium (as control group) to the subjects' feet. The data were analyzed by SPSS software using independent two-sample t-test, chi-square test, and one-way repeated measures analysis of variance (ANOVA). 12 male and 20 female patients participated in this study. There was a significant difference in the mean VAS, PSQI, physical dimension of the SF-36, and some NPS indices over time (12 weeks) (P < 0.001). The results of this study showed that BTX-A reduced neuropathic pain and improved the quality of life and sleep in people with diabetic neuropathy.

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False localizing signs of spinal CSF-venous fistulas in spontaneous intracranial hypotension: report of 2 cases.

A spinal CSF-venous fistula is one of three specific types of spinal CSF leak that can be seen in patients with spontaneous intracranial hypotension (SIH). They are best demonstrated on specialized imaging, such as digital subtraction myelography (DSM) or dynamic myelography, but often they are diagnosed on the basis of increased contrast density in the draining veins (the so-called hyperdense paraspinal vein sign) on early postmyelography CT scans. The authors report on 2 patients who underwent directed treatment (surgery in one patient and glue injection in the other) based on the hyperdense paraspinal vein sign, in whom the actual site of the fistula did not correspond to the level or laterality of the hyperdense paraspinal vein sign. The authors suggest consideration of DSM or dynamic myelography prior to undertaking treatment directed at these fistulas.

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Establishing User Requirements for a Norwegian IBD Mobile Application.

Six people with Inflammatory Bowel Disease (IBD) were interviewed in a natural setting with the purpose of defining requirements for a new IBD mobile application. The first part of the interview had open disease related questions, and the second part involved evaluating three publically available IBD applications. Results suggest that the most important user requirements could be met by implementing the following functionalities; registration of general well-being, bowel movements, and pain. All the study subjects believed in simple graphical solutions to register data and to represent the course of the disease in a satisfactory manner. It should be possible for a user to modify information and enter notes regarding changes of medication, diet, operations. The main features must meet the most general needs, while allowing users to enter unique information. This could serve as a practical guideline for developers.

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From Tertiary to Primary Care – Understanding Context in the Transfer of Digital Headache Service Pathway.

A digital service pathway for managing chronic headache has been designed in tertiary care in Finland. The digital tool facilitates self-management by providing exercises, information and messaging opportunities for patients. However, the largest potential benefits are in primaryand occupational care. Thus, the purpose of this study was to explore the needs and requirements of primary and occupational care actors for better understanding of the context in the transfer of the service. The study was performed as a single embedded case study. The qualitative data was collected through semi-structured interviews with 16 informants from different organizations and analyzed with Gioia-methodology. This study gathers important empirical knowledge about the meaning of context and transferring digital health interventions from one context to another from clinician and management perspective. Nine key contextual differences were identified and six main expectations emerged.

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Validity of the Budapest Criteria for Post-stroke Complex Regional Pain Syndrome.

Complex regional pain syndrome-1 (CRPS-1) is a chronic neuropathic disorder, and post-stroke CRPS (PS-CRPS) is not a rare complication. There is a lack of study implementing the Budapest criteria for PS-CRPS diagnosis. Thus, the present study investigated the validity of the Budapest criteria for PS-CRPS diagnosis and assessed the PS-CRPS-related factors in stroke patients with an affected upper extremity.

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Vestibular migraine.

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Factors associated with willingness to wear an electronic overdose detection device.

North America is in the midst of an opioid overdose epidemic. Although take-home naloxone and other measures have been an effective strategy to reduce overdoses, many events are unwitnessed and mortality remains high amongst those using drugs alone. While wearable devices that can detect and alert others of an overdose are being developed, willingness of people who use drugs to wear such a device has not been described.

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Rates of New Persistent Opioid Use After Vaginal or Cesarean Birth Among US Women.

Research has shown an association between opioid prescribing after major or minor procedures and new persistent opioid use. However, the association of opioid prescribing with persistent use among women after vaginal delivery or cesarean delivery is less clear.

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Comparison of the Pain-relieving Effects of Human Milk, Sucrose, and Distilled Water during Examinations for Retinopathy of Prematurity: A Randomized Controlled Trial.

This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity.

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Ultrasonic assessment of carotid intima-media thickness in migraine: a meta-analysis.

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