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Ischemic Stroke Management: Posthospitalization and Transition of Care
Am Fam Physician. 2023 Jul;108(1):70-77.ABSTRACTIschemic stroke is a major cause of morbidity and mortality worldwide. Ischemic stroke and transient ischemic attack exist on a continuum of the same disease process. Ischemic stroke is common, and more than 85% of stroke risk is attributed to modifiable risk factors. The initial management of acute stroke is usually performed in the emergency department and hospital settings. Family physicians have a key role in follow-up, ensuring that a complete diagnostic evaluation has been performed, addressing modifiable risk factors, facilitating rehabilitation, and managing chronic s...
Source: Pain Physician - July 13, 2023 Category: Anesthesiology Authors: Scott T Larson Brigit E Ray Jason Wilbur Source Type: research

Post-stroke shoulder pain: Nociceptive or neuropathic?
Acute rehabilitation after stroke can be adversely affected by complications such as pain in the hemiplegic shoulder. The onset of hemiplegic shoulder pain (HSP) can compromise functional gains, and has been shown to contribute to longer term disability . The first systematic study of the incidence of post-stroke shoulder pain (PSSP) found that 40% of patients were affected during the 3–6months following survival of a stroke . In 25% of patients, pain occurred during the first two weeks after stroke . The prognosis at six months, however, appears to be reasonably good, with 80% of patients reporting improvement or comple...
Source: Pain - November 26, 2012 Category: Anesthesiology Authors: Anthony K.P. Jones, Christopher A. Brown Tags: Commentaries Source Type: research

From preoperative evaluation to stroke center: Management of postoperative acute ischemic stroke
This article reviews the perioperative management (covering diagnosis and treatment), prevention (covering surgery postponement, management with anticoagulant/antiplatelet and the growing interest in statins and beta-blockers) and intraoperative recommendations (covering anaesthetic techniques, ventilation strategies, transfusion and blood pressure management) specifically for the general surgical population. A summary of current treatments is enlightened by recently described evidence for the effectiveness of mechanical thrombectomy.
Source: Anaesthesia, Critical Care and Pain Medicine - May 31, 2016 Category: Anesthesiology Source Type: research

Site of Nerve Division Affects Pain-Related Behavior and Spinal Cord Glial Proliferation after C7 Neurotomy in a Rat Stroke Model
CONCLUSION: The site of C7 neurotomy affects MPWT and spinal cord glial proliferation in rats with MCAO. Nerve division closer to intervertebral foramen resulted in lower MPWT and higher degree of glial proliferation in the spinal cord.PMID:35371367 | PMC:PMC8967577 | DOI:10.1155/2022/7446482
Source: Pain Research and Management - April 4, 2022 Category: Anesthesiology Authors: Zhenpeng Li Jintao Fang Jiantao Yang Bengang Qin Wenting He Jian Qi Qingtang Zhu Honggang Wang Liqiang Gu Source Type: research

Deficient pain modulation in patients with a chronic hemiplegic shoulder pain
ConclusionsThe results suggest that HSP is associated with a lack of pain adaptation, characteristic not only of the painful shoulder but also of the affected side. Although we cannot determine whether lack of pain adaptation precede the HSP or result from it, interventions that enhance descending pain inhibition may improve management and prevent HSP chronification.This article is protected by copyright. All rights reserved.
Source: Pain Practice - November 1, 2017 Category: Anesthesiology Authors: Yafit Kashi, Motti Ratmansky, Ruth Defrin Tags: Original Article Source Type: research

Deficient Pain Modulation in Patients with Chronic Hemiplegic Shoulder Pain
ConclusionsThe results suggest that HSP is associated with a lack of pain adaptation, characteristic not only of the painful shoulder but also of the affected side. Although we cannot determine whether lack of pain adaptation precedes the HSP or results from it, interventions that enhance descending pain inhibition may improve management and prevent HSP chronification.
Source: Pain Practice - January 11, 2018 Category: Anesthesiology Authors: Yafit Kashi, Motti Ratmansky, Ruth Defrin Tags: Original Article Source Type: research

The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department
DISCUSSION: AF is common in a Tanzanian EC, with thirty-day mortality being high, but use of evidence-based therapies is rare. There is an opportunity to improve AF care and outcomes in Tanzania.PMID:34703731 | PMC:PMC8524111 | DOI:10.1016/j.afjem.2021.07.002
Source: Pain Physician - October 27, 2021 Category: Anesthesiology Authors: Isaac O Oyediran Sainikitha Prattipati Francis M Sakita Godfrey L Kweka Tumsifu G Tarimo Timothy Peterson Zak Loring Alexander T Limkakeng Gerald S Bloomfield Julian T Hertz Source Type: research

Assessment of pain response in capsaicin-induced dynamic mechanical allodynia using a novel and fully automated brushing device.
CONCLUSIONS: A controlled, automatic brushing method can be used for quantitative investigations of allodynic reactions, and is more reliable for quantitative assessment of dynamic mechanical allodynia compared with traditional manual brushing. PMID: 23457680 [PubMed - indexed for MEDLINE]
Source: Pain Research and Management - January 1, 2013 Category: Anesthesiology Authors: du Jardin KG, Gregersen LS, Røsland T, Uggerhøj KH, Petersen LJ, Arendt-Nielsen L, Gazerani P Tags: Pain Res Manag Source Type: research

Safety and efficiency of ultrasound-guided intermediate cervical plexus block for carotid surgery
Conclusions The present work reports our first 50 cases of intermediate CPB using ultrasound guidance. The results underline that this technique is easy to perform, safe and reliable, provided good surgical conditions with continuous intraoperative neurologic monitoring and stable haemodynamics are respected.
Source: Anaesthesia, Critical Care and Pain Medicine - December 6, 2015 Category: Anesthesiology Source Type: research

Animal models for central poststroke pain: a critical comprehensive review
Abstract: Central poststroke pain (CPSP) is a severe type of neuropathic pain that can develop after stroke and is difficult to treat. Research into its underlying mechanisms and treatment options could benefit from a valid CPSP animal model. Nine different CPSP animal models have been published, but there are relatively few reports on successful reproductions of these models and so far only little advances in the understanding or the management of CPSP have been made relying on these models. In general, the construct validity (similarity in underlying mechanisms) of these CPSP animal models is relatively high, although th...
Source: Pain - December 30, 2016 Category: Anesthesiology Tags: Comprehensive Review Source Type: research

Transcranial Direct Current Stimulation for the Management of Neuropathic Pain: A Narrative Review
CONCLUSION: The results of the included studies suggest that tDCS may be beneficial in treating patients with NP due to stroke, spinal cord injury, multiple sclerosis, and trigeminal neuralgia. Further studies are recommended to validate the efficacy of tDCS in treating other types of NPs.PMID:34554695
Source: Pain Physician - September 23, 2021 Category: Anesthesiology Authors: Seoyon Yang Min Cheol Chang Source Type: research

Standardised data collection in prehospital critical care: a comparison of medical problem categories and discharge diagnoses
CONCLUSIONS: Medical problems reported by HEMS personnel have adequate correspondence to hospital discharge diagnoses. However, the classification of cerebrovascular accidents remains challenging.PMID:35413859 | DOI:10.1186/s13049-022-01013-5
Source: Pain Physician - April 13, 2022 Category: Anesthesiology Authors: Miretta Tommila Jukka Pappinen Lasse Raatiniemi Anssi Saviluoto Tuukka Toivonen Johannes Bj örkman Jouni Nurmi Source Type: research

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