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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We examined the effect of cognitive behavioral therapy for insomnia (CBT-I) and pain (CBT-P) on cortical thickness.Methods:Patients with fibromyalgia and insomnia underwent MRI before and after random assignment to CBT-I (n = 14), CBT-P (n = 16), or waitlist control (WLC; n = 7).Results:Repeated-measures analyses of variance revealed significant interactions for two regions (left lateral orbitofrontal cortex, left rostral middle frontal,Ps
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
This study was conducted to investigate the impact of migraine on the clinical presentation of insomnia symptoms.MethodsThe data of the Korean Headache-Sleep Study (KHSS) were used in the present study. The KHSS is a nation-wide cross-sectional population-based survey regarding headache and sleep in Korean adults aged 19 to 69  years. If a participant’s Insomnia Severity Index (ISI) score ≥ 10, she/he was classified as having insomnia. The clinical presentation of insomnia symptoms was assessed using total and subcomponent scores of the ISI.ResultsOf 2695 participants, 290 (10.8%) and 143 (5.3%)...
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
The new Pluta Integrative Oncology&Wellness Center is the first program of its kind in the region. It is designed to help patients incorporate complementary therapies and lifestyle modifications into their cancer treatment plans to address side effects such as fatigue, insomnia, anxiety, stress, pain and nausea.
Source: University of Rochester Medical Center Press Releases - Category: Universities & Medical Training Authors: Source Type: news
The new Pluta Integrative Oncology&Wellness Center is the first program of its kind in the region. It is designed to help patients incorporate complementary therapies and lifestyle modifications into their cancer treatment plans to address side effects such as fatigue, insomnia, anxiety, stress, pain and nausea.
Source: University of Rochester Medical Center Press Releases - Category: Universities & Medical Training Authors: Source Type: news
CONCLUSIONS: This review highlights the feasibility and possible benefits of MBSR and MBCT for older adults. Additional large scale RCTs conducted with older adults coping with the range of physical, behavioral, and cognitive challenges older adults commonly face still are needed. CLINICAL IMPLICATIONS: MBSR may be a promising intervention for older adults experiencing a variety of health concerns and possibly even cognitive decline. MBCT may reduce geriatric anxiety, although its effects on geriatric depression were not measured. PMID: 30204557 [PubMed - as supplied by publisher]
Source: Clinical Gerontologist - Category: Geriatrics Tags: Clin Gerontol Source Type: research
Anxiety and Anxiety Disorders Anxiety is a complex condition that affects millions of people all over the world. It is a broad term in itself and can look different on everybody. It is literally defined as: “a nervous disorder characterized by a state of excessive uneasiness and apprehension, typically with compulsive behavior or panic attacks.” Often times, anxiety and addiction can also go hand-in-hand. Much like anxiety, panic attacks can be completely different for everybody who experiences them. You may experience all symptoms, or only some. Some symptoms of anxiety and panic attacks may include: Rapid he...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Addiction Addiction Recovery Addiction to Pharmaceuticals Addiction Treatment and Program Resources Alcohol Alcohol Rehab Information Alcoholism Anxiety Drug Rehab Information Drug Treatment Dual Diagnosis and Eating Disorder Treatment Source Type: blogs
One of the aspects of depression that’s particularly difficult is the sleep disturbance which accompanies it and often continues after the traditional symptoms of depression have finally gotten better. When studied in the laboratory, the sleep of depressed person is short, shallow (with less deep slow-wave sleep), and frequently interrupted by awakenings. Additionally, there are abnormalities of the timing of rapid eye movement sleep and intensity of eye movements during REM. Dreams often have a depressive tone, and some sleep scientists speculate that there is a dysfunction of a normal process in which they provide ...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Psychiatry Source Type: blogs
Conclusion: PCS could consist of RUQ pain and diarrhea. Well-designed prospective trials are needed to determine risk factors of PCS. PMID: 30182019 [PubMed]
Source: Annals of Surgical Treatment and Research - Category: Surgery Tags: Ann Surg Treat Res Source Type: research
Authors: Ross IL, Jones J, Blockman M Abstract There are numerous articles in the lay press discussing the existence and under-diagnosis of adrenal fatigue. Proponents of adrenal fatigue state that millions of people have under-active adrenal glands due to repeated stressors, resulting in numerous nonspecific symptoms such as fatigue, insomnia, joint pain and weight gain, among others. In studies to date, proposed methods to assess adrenal fatigue have produced conflicting results and the methodology for assessing the hypothalamic-pituitary-adrenal (HPA) axis has often been inappropriate. Furthermore, only a minori...
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
This study aimed to determine if pain intensity moderates the association between opioid use and insomnia symptoms among adults with comorbid symptoms of insomnia and chronic widespread pain.
Source: Sleep Medicine - Category: Sleep Medicine Authors: Tags: Original Article Source Type: research
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