Preoperative Pain Control in Arthroscopic Rotator Cuff Repair: Does It Matter?
Preoperative Pain Control in Arthroscopic Rotator Cuff Repair: Does It Matter? Clin Orthop Surg. 2019 Jun;11(2):192-199 Authors: Tonotsuka H, Sugaya H, Takahashi N, Kawai N, Sugiyama H, Marumo K Abstract Background: The purpose of this study was to clarify the importance of preoperative pain control using corticosteroid injections in patients with persistent rest pain (RP) before arthroscopic rotator cuff repair (ARCR). Methods: A total of 360 patients (374 shoulders) who underwent primary ARCR and were followed up for at least 2 years were enrolled. After one-to-one propensity score matching, 266 patients (145 men and 128 women, 273 shoulders) were included in the study. Their mean age was 65.2 ± 7.7 years (range, 42 to 88 years) at the time of surgery. The patients were divided into three groups: those who required several intra-articular or subacromial bursa corticosteroid injections preoperatively for refractory RP (group A+), those in whom RP was resolved preoperatively (group A-), and those who had no RP and did not require any injections (group B). The incidence of postoperative RP and preoperative and final follow-up American Shoulder and Elbow Surgeons (ASES) scores were compared among the three groups. Results: The incidence of postoperative RP was significantly higher in group A+ (35/91 cases, 38.5%) than in group A- (10/91, 11.0%) and group B (7/91, 7.7%, p
Authors: Ye X, Gray E, Wang YF, Wang SJ Abstract Objectives: To assess the cost-effectiveness of mirogabalin versus no treatment or pregabalin in patients with post-herpetic neuralgia (PHN) from a third-party perspective in Taiwan.Methods: A Markov model, which was developed with 2-week cycles and 1-year time horizon from the Taiwanese National Health Insurance Administration perspective, consisted of three health states: 'mild', 'moderate' and 'severe' pain. Average daily pain score (ADPS) was assessed at the end of each cycle. Patients either remained in, or transitioned from, their assigned health state to a dif...
Conclusions: Valoctocogene roxaparvovec was found to be cost-saving-on average by about $6.8 million per patient-and more effective than prophylactic therapy for treatment of hemophilia A. The comparative benefit of gene therapy was observed across a broad range of simulated patients that were representative of the real-world severe hemophilia A population. PMID: 31971453 [PubMed - as supplied by publisher]
A 50-year-old man driving a motorcycle at 100 kph crashed at a curve on a racing course. On arrival, he had clear consciousness, and his vital signs showed mild hypertension and tachycardia. His chief complaint was general pain. The only physiological fin...
Conclusions: Alleviation of pain can be achieved in most patients with femoral and tibial shaft fractures, including multiply injured patients, with one-on-one patient support and by using nothing stronger than codeine and tramadol. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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CONCLUSIONS: TAK does co-occur with IBD, AS and less frequently with BS in about 1/5 of the patients, at least in a hospital setting. There is no clear temporal pattern. The high prevalence of inflammatory back pain in the dorsal spine in TAK needs further scrutiny. PMID: 31969224 [PubMed - as supplied by publisher]
Opioids are commonly prescribed to manage pain in patients with IBD despite increasing evidence of harm associated with chronic use. The aim of the current study was to describe trends in opioid use among veterans with IBD.
While restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the preferred surgical approach in patients with medically refractory ulcerative colitis (UC) or UC-related dysplasia, a significant proportion of patients develop pouchitis and/or report decreased health related quality of life (HRQOL) at some point after IPAA. We designed this study to 1) evaluate the association between recently reported pouchitis and specific Patient-Reported Outcome Measurement Information System (PROMIS) domains (anxiety, depression, fatigue, pain interference, sleep disturbance, and social role satisfaction) and HRQOL as a...
Living with Inflammatory Bowel Disease (IBD) has been associated with increased psychosocial stress among pediatric IBD populations. Elevated psychological stress can exacerbate disease activity and IBD symptoms like abdominal pain, which in turn can negatively impact children ’s mental health. There is an increasing need for mind-body interventions that can improve biopsychosocial processes among youth with IBD. Mindfulness-based interventions (MBIs) have been shown to be efficacious in improving emotional distress, pain, and inflammation in a range of pediatric and ad ult chronic illness/pain populations.
There is a need for reliable, valid patient-reported outcome (PRO) measures to assess the health and quality of life in pediatric Crohn ’s disease (PCD). The development of PROs for this population may be facilitated by using Patient-Reported Outcomes Measurement Information System (PROMIS) item banks, which were developed using rigorous psychometric methods. We aimed to develop disease-specific PROMIS short forms by conducting qu alitative research to identify the items that are most relevant to children with PCD.