Pain physician
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Randomized Controlled Trial
Clinical Trial of Ozonated Water Enema for the Treatment of Fibromyalgia: A Randomized, Double-Blind Trial.
The pathogenesis of fibromyalgia (FM) is currently unknown. Many patients with this condition are not effectively treated, and disorders of the intestinal dysbiosis have been identified in patients with FM. This trial aimed to investigate whether ozonated water enema could alleviate the symptoms of FM by improving intestinal dysbiosis in these patients. ⋯ This trial confirmed that the symptoms of pain, anxiety, and sleep disorders in FM patients were effectively relieved after treatment with an ozonated water enema. Furthermore, the ozonated water enema was associated with a significant reduction in duloxetine dosage and improved gut microbiome disorder, suggesting that the enema could target disorders related to the gut microbiome and therefore serve as a therapeutic intervention for FM.
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Serum 25-hydroxyvitamin D (25[OH]D) deficiency causes osteoporosis and increases muscle weakness, which worsens the risk of falls and osteoporotic vertebral fractures. However, the effect of a lower serum 25(OH)D level on new vertebral fractures, including osteoporotic vertebral refractures and cascade vertebral fractures post percutaneous vertebral augmentation in patients during postmenopause has not been reported. ⋯ A low serum 25(OH)D level is an independent risk factor for new vertebral fractures after percutaneous vertebral augmentation in patients during postmenopause. Appropriate active vitamin D supplementation following percutaneous vertebral augmentation surgery can effectively mitigate the risk of subsequent osteoporotic vertebral fractures.
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Observational Study
The Long-term Outcome of Usual and Unusual Indications for Spinal Cord Stimulation: A Prospective Study.
Evidence of the efficacy of spinal cord stimulation (SCS) has been well demonstrated as a method of pain control for patients who exhibit failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), and inoperable peripheral vascular diseases (PVD) ("usual indications"). However, a long-term study comparing the usual indications for which SCS is employed with those of other intractable painful conditions is still lacking. ⋯ Overall, SCS is an effective long-term treatment for chronic refractory pain. However, patients with usual indications for SCS have a higher success rate in SCS trials and a trend toward better outcomes after SCS implantation than do patients with unusual indications.
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Opioids, which are widely used during surgery in perioperative settings, may cause hyperalgesia, especially when the opioid employed is remifentanil. Opioid-induced hyperalgesia may increase the length of a patient's hospital stay and negatively affect enhanced recovery after surgery and the patient's prognosis. Currently, there is no consensus on treatment strategies for remifentanil-induced postoperative hyperalgesia (RIPH). ⋯ Our results demonstrated that the upregulation of LCN2 in the ACC plays a crucial role in the occurrence of RIPH, suggesting that LCN2 potentially be a therapeutic target for alleviating RIPH.