Clinical effectiveness of ultrasound guided subacromial-subdeltoid bursa injection of botulinum toxin type A in hemiplegic shoulder pain: A retrospective cohort study

Hemiplegic shoulder pain (HSP), which occurs in most patients with hemiplegia, causes considerable distress and worsens outcomes in rehabilitation. Although they have received the treatments such as anti-inflammatory drugs or physical therapy, many of the individuals remain suffering from shoulder pain 6 months after acute stroke event. In this retrospective study, we evaluated the effectiveness of ultrasound guided subacromial-subdeltoid (SASD) bursa injections with botulinum toxin type A (BoNT/A) compared to steroids for refractory HSP. The data were collected retrospectively by reviewing the patient's medical records and pain questionnaires in our rehabilitation center. In total, 38 patients who received ultrasound guided SASD bursa injection (BoNT/A group, n = 18; corticosteroid group, n = 20) were included. The pain visual analog scale (VAS) score at rest and during arm passive abduction, Fugl-Meyer score of upper limbs (F-M score) were evaluated before, 2, 4, 8, and 12 weeks after injection. Both 2 groups obtained a significant improvement of VAS score at rest or during arms passive abduction compared to baseline score (within group compare, P  .05). There were also no differences in results of the post treatment F-M score between 2 groups (between 2 groups compare, P > .05). Similarly, during the follow-up period no collateral effects were reported after BoNT/A injection. SASD bursa BoNT/A injection can substantially reduce the pain as corticoster...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

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...No rest for the caregiver. I climbed back in the car and fought my way through the streets to Mom. It wasn’t another false alarm. Mom really had fallen, and as usually happens after a fall, I couldn’t get her up off the floor by myself. I had to call the EMTs — again. Thankfully, this time she wasn’t seriously hurt. Hours later, once I’d settled Mom in her bed, I forced my way back through the still unplowed streets toward home, hoping for a couple of hours of sleep before morning, when I had to take my uncle to his neurology appointment for a post-stroke checkup. Continue reading on Health...
Source: Minding Our Elders - Category: Geriatrics Authors: Source Type: blogs
ConclusionIt is envisaged that the current review will add value to more scientific research on M. flabellifolius and enhance/promote the increased interest in the sustainable commercialization of M. flabellifolius herbal tea as well as lead to the validation of unverified ethnobotanical claims.Graphical abstract
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
Abstract Stroke is one of the world's most deadly pathologies, and the rate of stroke recurrence is high. However, due to the complex nature of ischemia and reperfusion injury, there is presently no reliable treatment. The main factors driving brain damage from ischemic stroke are neuronal cell death resulting from oxidative stress, inflammation, and failure of the blood brain barrier. While under normal conditions, the blood brain barrier acts as a selectively permeable membrane allowing solutes and other substances to pass into the tissues of the central nervous system, ischemia and reperfusion alter the express...
Source: Archives of Biochemistry and Biophysics - Category: Biochemistry Authors: Tags: Arch Biochem Biophys Source Type: research
In recent years, mediation analysis has become a popular means to identify and quantify pathways linking an exposure to an outcome, thereby elucidating how a particular exposure contributes to the occurrence of a specific outcome. When a mediator is a modifiable risk factor, this opens up new opportunities for interventions to block (part) of the exposure`s effect on the outcome. Recent examples in Scandinavian Journal of Work Environment Health have addressed the mediating effect of wellbeing on the association between type of office and job satisfaction (1) and examined whether workplace social capital contributes to the...
Source: Scandinavian Journal of Work, Environment and Health - Category: Occupational Health Tags: Editorial Source Type: research
An elderly woman with h/o stroke and aphasia seemed different to her daughter, and was pointing all over her body as if in pain.They called 911.She had a history of PCI to the circumflex and also of severe mitral regurgitation, status post bioprosthetic valve replacement.  Also a h/o LV aneurysm with thrombus, on anticoagulation, as well as a dual chamber pacemaker. On arrival, the BP was 60/30.Here is the initial ECG:There is atrial pacing and Right Bundle Branch Block (RBBB)There is STE in I and aVL, V5, V6, with reciprocal STD in II, III, aVFThere is appropriately discordant ST depression in V1-V3 (appropriate...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
(University of Western Ontario) The study demonstrated for the first time that in people with no underlying heart disease, after a stroke they were more than 20 times more likely than those who didn't have a stroke (23-fold in women and 25-fold in men) to have a first-in-life major adverse cardiovascular event. These events include things like heart attack, chest pain, cardiac failure or cardiac death.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Abstract Although the prevalence of muscle weakness in the general population is uncertain, it occurs in about 5% of U.S. adults 60 years and older. Determining the cause of muscle weakness can be challenging. True muscle weakness must first be differentiated from subjective fatigue or pain-related motor impairment with normal motor strength. Muscle weakness should then be graded objectively using a formal tool such as the Medical Research Council Manual Muscle Testing scale. The differential diagnosis of true muscle weakness is extensive, including neurologic, rheumatologic, endocrine, genetic, medication- or tox...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
Photo credit Jeremy Wong Dear Carol: My dad, who had been Mom’s caregiver for years, died suddenly from a stroke. I can’t say that I’m surprised because he was under enormous stress trying to cope with first Mom’s illness from cancer treatments, and more recently her early-stage Alzheimer’s diagnosis. Needless to say, we’re all heartbroken over Dad’s sudden death as well as up in the air about how to handle Mom. She seems to be in total denial, though some of her repeated questions may be due to occasional short-term memory loss. How do we help her with this shock and grief? &mdash...
Source: Minding Our Elders - Category: Geriatrics Authors: Source Type: blogs
Pain is a common and burdensome complication in patients with acute stroke. We assessed the impact of impaired communication in stroke patients on pain assessment and treatment.
Source: BMC Neurology - Category: Neurology Authors: Tags: Research article Source Type: research
Semin Neurol DOI: 10.1055/s-0039-3402737Isolated dizziness and vertigo due to vascular mechanisms are frequently misdiagnosed as peripheral vestibulopathy or vestibular migraine. For diagnosis of strokes presenting with an acute prolonged (≥ 24 hours) vestibular syndrome, findings on clinical examination, such as HINTS (negative head impulse tests, detection of direction-changing gaze-evoked nystagmus, and presence of skew deviation), are more sensitive than findings on neuroimaging. Since HINTS alone cannot securely detect anterior inferior cerebellar artery strokes, additional attention should be paid to the pa...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
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