Multiple Low Doses of Intravenous Corticosteroids to Improve Early Rehabilitation in Total Knee Arthroplasty: A Randomized Clinical Trial

J Knee Surg DOI: 10.1055/s-0038-1636506Low doses of corticosteroids have been proved to be effective in decreasing the inflammatory cytokines and relieving the pain. However, the optimal dosage of corticosteroids in total knee arthroplasty (TKA) is undetermined. A total of 103 patients were randomly divided into three groups. Group A containing 32 patients received normal saline. Group B including 36 patients used two doses of 100 mg hydrocortisone, given 2 hours before and 8 hours after surgery. Group C involving 35 patients received four doses of 100 mg hydrocortisone, 8 hours apart.The level of interleukin 6 (IL-6) and C-reactive protein (CRP) were lower in group C than those in group A when detected at 12, 24, and 48 hours after operation and even lower than that in group B at 24 and 48 hours (p  0.05), but it did not show statistic difference 24 hours later (p > 0.05). For comparison, patients with multiple doses achieved continuously better outcomes on pain management than the blank control group within postoperative 36 hours at rest and at 24 hours with activity. In addition, patients using multiple doses of hydrocortisone achieved fewer occurrences of nausea and vomiting, fever, and sleeplessness, better knee function recovery, better patient satisfaction, and shorter length of hospital stays (p 
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

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CONCLUSIONS: Although HRQoL remains relatively stable over time, HRQoL data needs to be interpreted with care as many confounding factors can have an impact on HRQOL. Our data (which is freely available) can aid in the interpretation of QLQ-C30 scores and can help increase our understanding of the influence of age, sex, time and morbid conditions on HRQoL among cancer patients. PMID: 29912607 [PubMed - as supplied by publisher]
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
Last week I wrote about my approach to assessing sleep problems in those with persistent pain. As an ex-insomniac I’ve spent a while learning about sleep so I can understand what’s going on, and why sleep can be such a problem. In this week’s post I want to dig a little deeper into what’s going on with poor sleep, as well as some of the unique features of sleep in people experiencing persistent pain. Having reviewed the five main areas that are fundamental (and can/should be assessed by anyone working with people who experience persistent pain), the next area I want to look at with people is mood. T...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Chronic pain Clinical reasoning Health Pain conditions Research biopsychosocial coping disability function pain management treatment Source Type: blogs
Conclusion Anxiety, stress management and pain scores were the most improved. Wellbeing scores also improved, on average, by two points on the Likert scale. Patients have stated that ‘being listened to’ and ‘being heard’ were important factors when describing how Shiatsu had helped. We suggest that a study using larger numbers is necessary in order to provide more robust evidence rather than emerging trends.
Source: European Journal of Integrative Medicine - Category: Complementary Medicine Source Type: research
(Natural News) If you suffer from stress, anxiety, insomnia, pain, or post-traumatic stress disorder (PTSD), therapeutic rocking can help ease your symptoms. This natural treatment is beneficial not only for the person being rocked but also for the person doing the rocking. Done properly, therapeutic rocking can be practiced daily to help relieve stress and anxiety....
Source: NaturalNews.com - Category: Consumer Health News Source Type: news
Conclusions:Sleep problems are common among female veterans (47.39%) despite limited diagnosis of sleep disorders (0.90%). Eight unique subgroups of female veterans with both low and high insomnia symptoms were observed. These subgroups differed in terms of psychosocial functioning and health care utilization, with those with depression, posttraumatic stress disorder, and pain having the poorest outcomes. These results shed light on the prevalence of insomnia symptoms experienced among female veterans and the effect on psychosocial functioning and health care utilization. Results can inform targeted detection and customize...
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
Problems with sleep affect most of us from time to time. We know we might find it difficult to get off to sleep because of a busy mind, a different bedroom, changes to our schedule – but for most of us, sleep returns to our normal fairly quickly. For some of us, though, sleep problems continue for weeks, months or even years. And for people living with persistent pain, sleep can be one of the most difficult things to deal with, yet it’s also one of the most common (McCracken &Iverson, 2002). Studies of sleep problems in people with fibromyalgia show abnormal sleep continuity as well as changes in sleep arch...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Clinical reasoning Coping Skills Coping strategies Health Pain conditions Therapeutic approaches acceptance Assessment biopsychosocial science treatment Source Type: blogs
CONCLUSION: The accuracy of the clinical features of patients with depression in primary care will facilitate the detection of these disorders by general practitioners and improve management of depression. PMID: 29866509 [PubMed - as supplied by publisher]
Source: Revue d Epidemiologie et de Sante Publique - Category: Epidemiology Tags: Rev Epidemiol Sante Publique Source Type: research
Abstract OBJECTIVE: Overweight/obesity and chronic pain frequently co-occur and demonstrate a bidirectional relationship. Modifiable risk factors, such as eating behaviors and mental health symptoms, may be important to understand this relationship and improve interventions in Veterans. DESIGN: Cross-sectional. SETTING: Veterans Health Administration Medical Center outpatient clinic. SUBJECTS: The sample of Veterans (N = 126) was mostly male (89.7%), White (76%), and non-Hispanic (94%) with average age of 61.9 years (SD = 8.5) and average body mass index (BMI) of 38.5 (SD = 7.5). ME...
Source: Appetite - Category: Nutrition Authors: Tags: Appetite Source Type: research
We present a case report on Cycloserine induced Suicidal tendencies and Kanamycin induced decrease in hearing sensation in Indian MDR-TB patient. CASE REPORT: A 55-year-old male patient who was diagnosed with MDR-TB was prescribed with category IV anti-tubercular therapy. Within one month of initiation of therapy, he developed repeated suicidal thoughts, joint pain, restlessness, depression, constipation, insomnia, tinnitus and a decrease in hearing sensation. RESULTS: Cycloserine and kanamycin were closely associated with suicidal tendency and tinnitus followed by decrease in hearing sensations respectively. On ...
Source: Current Drug Safety - Category: Drugs & Pharmacology Authors: Tags: Curr Drug Saf Source Type: research
This study suggests that GAAE possess active compounds, which exert marked protective effects in experimental colitis, possibly by regulating the colonic epithelium inflammatory mediators, oxidative balance and calcium homeostasis. Graphical abstract
Source: Journal of Functional Foods - Category: Nutrition Source Type: research
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