New recommendations aim to improve safety of pain-relieving spinal steroid injections
More and more people are seeking injections of anti-inflammatory steroid medications for back and neck pain. In 2011, the last year for which complete information is available, doctors pushed the plunger on 2.3 million steroid injections into the spine — and that’s just among people covered by Medicare. These injections deliver drugs that mimic the effects of two hormones, cortisone and hydrocortisone, to reduce inflammation and help relieve pain. When they work — they don’t always — such injections can bring profound relief. “If you are in severe pain with a ruptured spinal disc and you get a steroid injection, you are going to feel better sooner,” says Dr. James P. Rathmell, professor of anesthesia at Harvard Medical School. “That’s the good part.” But there’s a bad part, too. Steroid injections into the spine can cause partial or total paralysis, brain damage, stroke, and even death. This week, in a Viewpoint article in The Journal of the American Medical Association, Dr. Rathmell and two colleagues spotlight their new safety recommendations to help prevent these rare but real problems. “There are these very, very small risks of some serious adverse effects that we think we can prevent,” says Dr. Rathmell. “If you perform these injections in the safest way, I think the risk becomes exceedingly low.” It’s hard to pin down exactly how often spinal injections go awry. Dr. Rathmell ...
We describe the most highly recommended generic and disease-specific PRO tools in SCD and discuss the challenges of incorporating them in clinical practice. EXPERT OPINION: PRO measures are essential to incorporate into SCD clinical trials either as primary or secondary outcomes. The use of PRO measures in SCD facilitates a patient-centered approach, which is likely to lead to improved outcomes. Significant challenges remain in adapting PRO tools to routine clinical use and in developing countries. PMID: 33034214 [PubMed - as supplied by publisher]
Publication date: Available online 10 October 2020Source: Meta GeneAuthor(s): Mansour Zamanpoor, Hamid Ghaedi, Mir Davood Omrani
Authors: Sabet Sarvestani F, Azarpira N Abstract Heart and cerebral infarctions, as two important ischemic diseases, lead to the death of tissues due to inadequate blood supply and high mortality worldwide. These statuses are started via blockage of vessels and depletion of oxygen and nutrients which affected these areas. After reperfusion and restoration of oxygen supply, more severe injury was mediated by multifaceted cascades of inflammation and oxidative stress. microRNAs (miRNAs) as the regulator of biological and pathological pathways can adjust these conditions by interaction with their targets. Also, miRNAs...
Currently in fellowship doing bread/butter procedures (MBB, epidurals, PNB, few SCS/PNS trials, etc.) and just interviewed at a private practice spot where they do a lot of procedures that I will have not done any training in prior to graduating (e.g. IT pump, SI fusion, Vertiflex, Kypho, MILD, Discectomy, lots of SCS/PNS trials etc) and significant amount of "OR pain procedures" at a very busy practice seeing 30-40 pts/day - how many of you are commonly performing these procedures and are... private practice concern
In this study, an attempt to oxidise the surface of a commercial activated carbon to improve its adsorption capacity for sevoflurane was conducted using 6 mol/L nitric acid, 2 mol/L ammonium persulfate, and 30 wt per cent (wt%) of hydrogen peroxide (H2O2). The adsorption tests at fixed conditions (bed depth: 10 cm, inlet concentration: 528 mg/L, and flow rate: 3 L/min) revealed that H2O2 oxidation gave desirable sevoflurane adsorption (0.510 ± 0.005 mg/m2). A parametric study was conducted with H2O2 to investigate the effect of oxidation conditions to the changes in surfa...
Publication date: Available online 9 October 2020Source: NeuropsychologiaAuthor(s): Erin L. Meier, Shannon M. Sheppard, Emily B. Goldberg, Catherine R. Head, Delaney M. Ubellacker, Alexandra Walker, Argye E. Hillis
Publication date: Available online 9 October 2020Source: Neurología (English Edition)Author(s): J.P. Martínez-Barbero, P. Tomás-Muñoz, R. Martínez-Moreno
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): Fernando Lopes, Fernando A. Vicentini, Nina L. Cluny, Alexander J. Mathews, Benjamin H. Lee, Wagdi A. Almishri, Lateece Griffin, William Gonçalves, Vanessa Pinho, Derek M. McKay, Simon A. Hirota, Mark G. Swain, Quentin J. Pittman, Keith A. Sharkey
BEST supplements to relieve joint pain: Is your arthritis playing up? The wetter and colder months could partially be to blame. These two pills may help.
Authors: Mantero V, Rigamonti A, Basilico P, Sangalli D, Scaccabarozzi C, Salmaggi A PMID: 33029982 [PubMed]
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