Articles: chronic.
-
Reg Anesth Pain Med · May 2014
Comparative StudyClinical Effectiveness of Percutaneous Adhesiolysis Versus Transforaminal Epidural Steroid Injection in Patients With Postlumbar Surgery Syndrome.
A number of patients with postlumbar surgery syndrome (PLSS) do not experience satisfactory results after epidural injection. A main reason for failure is surgically induced perineural fibrosis impeding injected material from spreading effectively into the target area. Percutaneous adhesiolysis (PA) has the ability to eliminate the deleterious effects of such adhesions. This study was to evaluate the effectiveness of PA versus transforaminal epidural steroid injection (TFESI) for treating patients with PLSS and to compare the clinical efficacy of PA according to the type of surgery. ⋯ Percutaneous adhesiolysis was more effective than TFESI in treating patients with PLSS and also showed better clinical efficacy in the decompression subgroup than in the fusion subgroup.
-
Am. J. Respir. Crit. Care Med. · May 2014
Outcomes Associated with Corticosteroid Dosage in Critically Ill Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease.
Studies evaluating corticosteroid (CS) dosing for patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) have largely excluded patients admitted directly to the intensive care unit (ICU), and none have evaluated the effect of CS dosing regimens on mortality. ⋯ Two-thirds of patients admitted to the ICU with an AECOPD are treated with high doses of CS that are associated with worse outcomes and more frequent adverse effects. Lower dosage strategies should be encouraged for patients admitted to the ICU and the optimum dose should be determined through clinical trials.
-
Am. J. Respir. Crit. Care Med. · May 2014
Clinical TrialShould we view COPD Differently after ECLIPSE? A Clinical Perspective from the Study Team.
Chronic obstructive pulmonary disease (COPD) seems to be a heterogeneous disease with a variable course. ⋯ By following a large, well characterized cohort of patients with COPD over 3 years, we have a clearer picture of a heterogeneous disease with clinically important subtypes ("phenotypes") and a variable and not inherently progressive course. Clinical trial registered with www.clinicaltrials.gov (NCT00292552).
-
Background: Pulsed radiofrequency (PRF) has been widely used to treat chronic pain, but the effectiveness and mechanisms in preventing early neuropathic pain have not been well explored. Even fewer knowledge is available in its impact on glia-mediated nociceptive sensitization. This study aims to elucidate the modulation of PRF on nerve injury-induced pain development and activation of spinal mitogen-activated protein kinases (MAPKs). ⋯ Conclusions: Low-volt PRF significantly ameliorated SNL-induced acute pain. Inferentially, PRF may inhibit spinal sensitization by down-regulating spinal MAPK activations and activation-mediated cytokine release. We demonstrated that early PRF treatment in acute nerve injury helps to ameliorate neuropathic pain development.
-
Ann Fr Anesth Reanim · May 2014
Observational StudyRisk factors for persistent pain after urological surgery.
Ten to 50% of patients with post-surgical pain develop chronic pain depending on the type of surgery. The objective of this study was to assess the incidence of persistent post-surgical pain (PPSP) and to identify risk factors following urology surgery. ⋯ These findings confirm the role of preoperative pain and morphine consumption in the genesis of PPSP and call for establishing clinical perioperative pathways tailored to the patient.