Pub Date : 2017-05-17DOI: 10.4172/2167-0846.1000289
Chan Xh Diana, L. Lydia, Tan Kh
Introduction: Pain affects the quality of life in cancer patients. The World Health Organization established a simple three-step “ladder” approach in 1986, beginning with nonopioid drugs and progressing to stronger opioids as necessary. The implementation of this guideline enables analgesia to be achieved in 75% to 90% of patients. The remaining patients suffer from intractable pain requiring intrathecal analgesia. Advances in intrathecal analgesia and intrathecal drug delivery systems have allowed for a range of medications to be used in the control of pain in the remaining 20% of patients with intractable cancer pain. This technique allows for reduced medication doses that can decrease the side effects typically associated with oral or parenteral drug delivery. We aim to analyse the pain intensity before and after intrathecal analgesia and review the complications associated with the implantation and the care of the intrathecal device. Materials and Methods: We retrospectively analysed medical records of all cancer patients whose pain were managed by intrathecal catheter implants in our centre from February 2005 to December 2014. The pain intensity was reviewed at the time prior to administration of intrathecal analgesia and at physician review prior to hospital discharge or death. Complications related to intrathecal analgesia were reviewed from the patients’ medical records. Results: We analysed the data obtained from 44 patients. 86.4% had metastatic cancer. Pain intensity was reduced significantly at the time of discharge from hospital (P<0.001). Opioids side effects were reduced after intrathecal treatment. The main catheter-related complications were catheter displacement and infection. Conclusion: Intrathecal catheter insertion and analgesia is a safe and effective method of pain control in patients with intractable cancer pain.
{"title":"Intrathecal Catheter Insertion and Analgesia is a Safe and Effective Method ofPain Control in Patients with Advanced and Intractable Cancer Pain","authors":"Chan Xh Diana, L. Lydia, Tan Kh","doi":"10.4172/2167-0846.1000289","DOIUrl":"https://doi.org/10.4172/2167-0846.1000289","url":null,"abstract":"Introduction: Pain affects the quality of life in cancer patients. The World Health Organization established a simple three-step “ladder” approach in 1986, beginning with nonopioid drugs and progressing to stronger opioids as necessary. The implementation of this guideline enables analgesia to be achieved in 75% to 90% of patients. The remaining patients suffer from intractable pain requiring intrathecal analgesia. Advances in intrathecal analgesia and intrathecal drug delivery systems have allowed for a range of medications to be used in the control of pain in the remaining 20% of patients with intractable cancer pain. This technique allows for reduced medication doses that can decrease the side effects typically associated with oral or parenteral drug delivery. We aim to analyse the pain intensity before and after intrathecal analgesia and review the complications associated with the implantation and the care of the intrathecal device. \u0000Materials and Methods: We retrospectively analysed medical records of all cancer patients whose pain were managed by intrathecal catheter implants in our centre from February 2005 to December 2014. The pain intensity was reviewed at the time prior to administration of intrathecal analgesia and at physician review prior to hospital discharge or death. Complications related to intrathecal analgesia were reviewed from the patients’ medical records. \u0000Results: We analysed the data obtained from 44 patients. 86.4% had metastatic cancer. Pain intensity was reduced significantly at the time of discharge from hospital (P<0.001). Opioids side effects were reduced after intrathecal treatment. The main catheter-related complications were catheter displacement and infection. \u0000Conclusion: Intrathecal catheter insertion and analgesia is a safe and effective method of pain control in patients with intractable cancer pain.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91196828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-12DOI: 10.4172/2167-0846.1000288
R. Papalia, B. Zampogna, G. Vadalà, A. Martino, C. Nobile, A. Buono, G. Torre, M. Tirindelli, N. Maffulli, V. Denaro
Introduction: Chronic overuse insertional tendinopathy (entesopathy) is highly prevalent, but is an extremely difficult condition that generates a high medical expense. Alternative and co-adjuvant therapies to improve the quality of life and physical function of affected patients are currently being sought. Materials and Methods: A total of 31 patients affected by entesopathy at different anatomical sites (elbow tendinopathy, greater trochanter pain syndrome and plantar fasciopathy) were treated with three peritendinous injections of autologous platelet rich plasma (PRP) and included in the present investigation. VAS scale and segmental scores for the affected site before the first injection of PRP and at 6 months after the last injection were used. One hundred and seven patients that underwent the same injection protocol in the same time lapse were used as a control group, and were represented by patients with non-insertional tendinopathy (shoulder and at Achilles tendon). Results: Significantly lower values between pre-treatment and follow-up pain scores at all-time points were found in the patients affected by entesopathy compared to tendinopathy (p<0.001). As a confirmative finding, the segmental scores at the shoulder and ankle did not improve overtime, differently from what occurred in patients with entesopathy. Conclusion: At 6 months following peritendinous injections of PRP in patients with entesopathy there was a significant reduction of pain, associated to a significant improvement in recorded segmental scores. Conversely, the treatment was not effective in patients with pure tendinopathy at the shoulder and ankle level. These favorable findings point to consider PRP as a promising therapy for patients affected by entesopathy.
{"title":"Are Platelet Rich Plasma Injections More Effective in Tendinopathy orEnthesopathy","authors":"R. Papalia, B. Zampogna, G. Vadalà, A. Martino, C. Nobile, A. Buono, G. Torre, M. Tirindelli, N. Maffulli, V. Denaro","doi":"10.4172/2167-0846.1000288","DOIUrl":"https://doi.org/10.4172/2167-0846.1000288","url":null,"abstract":"Introduction: Chronic overuse insertional tendinopathy (entesopathy) is highly prevalent, but is an extremely difficult condition that generates a high medical expense. Alternative and co-adjuvant therapies to improve the quality of life and physical function of affected patients are currently being sought. \u0000Materials and Methods: A total of 31 patients affected by entesopathy at different anatomical sites (elbow tendinopathy, greater trochanter pain syndrome and plantar fasciopathy) were treated with three peritendinous injections of autologous platelet rich plasma (PRP) and included in the present investigation. VAS scale and segmental scores for the affected site before the first injection of PRP and at 6 months after the last injection were used. One hundred and seven patients that underwent the same injection protocol in the same time lapse were used as a control group, and were represented by patients with non-insertional tendinopathy (shoulder and at Achilles tendon). \u0000Results: Significantly lower values between pre-treatment and follow-up pain scores at all-time points were found in the patients affected by entesopathy compared to tendinopathy (p<0.001). As a confirmative finding, the segmental scores at the shoulder and ankle did not improve overtime, differently from what occurred in patients with entesopathy. \u0000Conclusion: At 6 months following peritendinous injections of PRP in patients with entesopathy there was a significant reduction of pain, associated to a significant improvement in recorded segmental scores. Conversely, the treatment was not effective in patients with pure tendinopathy at the shoulder and ankle level. These favorable findings point to consider PRP as a promising therapy for patients affected by entesopathy.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83665887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-30DOI: 10.4172/2167-0846.1000286
Luara Lis Barbosa Boson, L. A. Oliveira, F. Moreira, M. Pereira, Rayssa Fernandes Souza Coelho, Allyson Coelho Ribeiro, A. Martins, José Hugo Andrade Santos Dantas, Isadora Costa Coelho Gayoso-Almendra, Í. A. Brandão, J. L. Gomes, Kamilla Gomes Sales Souza, L. Leal, Luís Gustavo Silva Bacelar Andrade, Vanessa Nepomuceno Fonseca Meneses, A. Soares, R. Silva-Néto
Headache attributed to airplane travel (HAAT) is a rare form of headache disorder that develops exclusively during plane travel. HAAT is characterized by occurring during takeoff or landing or both and improves spontaneously within 30 minutes after the ascent or descent of the airplane is completed. We report the case of a 9- year-old Brazilian boy with recurrent episodes of headache without associated symptoms occurring during airplane travel, but only during landing. Paranasal sinus tomography and brain magnetic resonance imaging did not reveal barotrauma or inflammation of the paranasal sinuses or any brain injury. This case fulfilled the diagnostic criteria for HAAT. It appears that HAAT may occur without prior history of barotrauma or inflammation of the paranasal sinuses.
{"title":"Headache Attributed to Airplane Travel in a Child-First Case in Brazil","authors":"Luara Lis Barbosa Boson, L. A. Oliveira, F. Moreira, M. Pereira, Rayssa Fernandes Souza Coelho, Allyson Coelho Ribeiro, A. Martins, José Hugo Andrade Santos Dantas, Isadora Costa Coelho Gayoso-Almendra, Í. A. Brandão, J. L. Gomes, Kamilla Gomes Sales Souza, L. Leal, Luís Gustavo Silva Bacelar Andrade, Vanessa Nepomuceno Fonseca Meneses, A. Soares, R. Silva-Néto","doi":"10.4172/2167-0846.1000286","DOIUrl":"https://doi.org/10.4172/2167-0846.1000286","url":null,"abstract":"Headache attributed to airplane travel (HAAT) is a rare form of headache disorder that develops exclusively during plane travel. HAAT is characterized by occurring during takeoff or landing or both and improves spontaneously within 30 minutes after the ascent or descent of the airplane is completed. We report the case of a 9- year-old Brazilian boy with recurrent episodes of headache without associated symptoms occurring during airplane travel, but only during landing. Paranasal sinus tomography and brain magnetic resonance imaging did not reveal barotrauma or inflammation of the paranasal sinuses or any brain injury. This case fulfilled the diagnostic criteria for HAAT. It appears that HAAT may occur without prior history of barotrauma or inflammation of the paranasal sinuses.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"178 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80679544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-30DOI: 10.4172/2167-0846.1000287
R. Casale, F. Ceccherelli, Gianpiero Buttacchio, Marzia Calabrese, A. Labeeb, Zaira Symeonidou
Acupuncture or dry needling, in clinical practice have been used successfully in the treatment of pain associated with muscle tone alterations. However a possible direct effect on muscle tone has never been clearly separated from its analgesic action. The H-reflex is a recognised neurophysiological index of the excitability of spinal motor neuron pool. This reflex is highly inhibited by the application of a vibration stimulus of 100 Hz. The aim of the study was to evaluate in a group of normal subjects and in absence of pain if acupuncture stimulation was capable of acting at the segmental level, modifying the 100 Hz vibratory inhibition of the H-reflex. H-reflex amplitude significantly varied in relation to the application of vibratory stimulus and acupuncture stimuli. Before vibration (H-Basal) the average amplitude was 292 ± 59.3 I¼V. During vibration (H-Vib) the amplitude reduced to 118 ± 73.6 I¼V (H-Bas vs. H-Vib p<0.05). Insertion of the needle (H-Vib+needle) produced a statistically significant increase in amplitude of the H-reflex to 218.8 ± 95 I¼V (H-Vib vs. H-Vib+Ago p<0.05). Through the use of neurophysiological techniques on man e.g. H-reflex, the existence of a direct effect of acupuncture on the excitability of the spinal motor neurons has been demonstrated suggesting an action of acupuncture on muscle tone separate from its well-known analgesic effect.
针灸或干针，在临床实践中已成功地用于治疗与肌肉张力改变相关的疼痛。然而，对肌张力可能的直接影响从未与它的镇痛作用明确分离。h反射是公认的反映脊髓运动神经元池兴奋性的神经生理指标。这种反射被100赫兹的振动刺激高度抑制。这项研究的目的是在一组正常受试者中，在没有疼痛的情况下，评估针灸刺激是否能够在节段水平上起作用，改变100赫兹的h反射振动抑制。h反射振幅与振动刺激和针刺刺激有关。振动前(h -基底)平均振幅为292 ±59.3 I¼V。振动(H-Vib)时振幅降至118 ±73.6 μ V (H-Bas vs. H-Vib p<0.05)。插入针(H-Vib+针)使h反射振幅增加到218.8 ±95 I¼V (H-Vib vs H-Vib+Ago p<0.05)，具有统计学意义。通过对人的神经生理学技术的应用，例如h反射，针刺对脊髓运动神经元兴奋性的直接影响已经被证明，这表明针灸对肌肉张力的作用与它众所周知的镇痛作用不同。
{"title":"Dry Needling Reverses Vibration-induced Changes in Spinal Motoneuronal Pool:Is there any Basis for its Action on Muscle Tone?","authors":"R. Casale, F. Ceccherelli, Gianpiero Buttacchio, Marzia Calabrese, A. Labeeb, Zaira Symeonidou","doi":"10.4172/2167-0846.1000287","DOIUrl":"https://doi.org/10.4172/2167-0846.1000287","url":null,"abstract":"Acupuncture or dry needling, in clinical practice have been used successfully in the treatment of pain associated with muscle tone alterations. However a possible direct effect on muscle tone has never been clearly separated from its analgesic action. The H-reflex is a recognised neurophysiological index of the excitability of spinal motor neuron pool. This reflex is highly inhibited by the application of a vibration stimulus of 100 Hz. The aim of the study was to evaluate in a group of normal subjects and in absence of pain if acupuncture stimulation was capable of acting at the segmental level, modifying the 100 Hz vibratory inhibition of the H-reflex. H-reflex amplitude significantly varied in relation to the application of vibratory stimulus and acupuncture stimuli. Before vibration (H-Basal) the average amplitude was 292 ± 59.3 I¼V. During vibration (H-Vib) the amplitude reduced to 118 ± 73.6 I¼V (H-Bas vs. H-Vib p<0.05). Insertion of the needle (H-Vib+needle) produced a statistically significant increase in amplitude of the H-reflex to 218.8 ± 95 I¼V (H-Vib vs. H-Vib+Ago p<0.05). Through the use of neurophysiological techniques on man e.g. H-reflex, the existence of a direct effect of acupuncture on the excitability of the spinal motor neurons has been demonstrated suggesting an action of acupuncture on muscle tone separate from its well-known analgesic effect.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84497253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-14DOI: 10.4172/2167-0846.1000285
K. Bevers, Ryan Hulla, O. Rice, G. Verdier, E. Salas, R. Gatchel
Chronic low back pain is a debilitating condition affecting millions of Americans annually. Older-adult populations suffer a high prevalence of this continually painful state, and further face a unique set of challenges to manage short- and long-term biopsychosocial functioning. As the population ages, and the proportion of older adults grow, it is essential to explore and develop the most effective interdisciplinary strategies to care for older adults who are chronic pain sufferers. In this Commentary, we highlight some of the special challenges that the older-adult population encounters, and their influence on pain management strategies.
{"title":"The Chronic Low Back Pain Epidemic in Older Adults in America","authors":"K. Bevers, Ryan Hulla, O. Rice, G. Verdier, E. Salas, R. Gatchel","doi":"10.4172/2167-0846.1000285","DOIUrl":"https://doi.org/10.4172/2167-0846.1000285","url":null,"abstract":"Chronic low back pain is a debilitating condition affecting millions of Americans annually. Older-adult populations suffer a high prevalence of this continually painful state, and further face a unique set of challenges to manage short- and long-term biopsychosocial functioning. As the population ages, and the proportion of older adults grow, it is essential to explore and develop the most effective interdisciplinary strategies to care for older adults who are chronic pain sufferers. In this Commentary, we highlight some of the special challenges that the older-adult population encounters, and their influence on pain management strategies.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77897670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-17DOI: 10.4172/2167-0846.1000284
J. Hesselink, D. Kopsky
We herewith describe a topical formulation of phenytoin with a clear analgesic effect in localized neuropathic pain: in post herpetic neuralgia and trigeminal neuralgia. Such topical analgesic effect for phenytoin has not yet been described in literature. We have developed various topical phenytoin formulations and identified a stable cream base in which we compounded a range of concentrations of phenytoin up to 10%. We will present two cases supporting the analgesic effect of phenytoin cream in neuralgic pain, and discuss the putative mechanism of action of phenytoin as a topical analgesic. The essence of both cases is that, apparently, it is possible to down-regulate central sensitization processes via the modulation (inhibition) of peripheral input. This hypothesis was brought forward in 2013 based on neurophysiological data, and our clinical data seem to also support this important chapter in pain treatment. Thus, topical analgesia, in our case based on phenytoin, can play an important role in multimodal therapy of chronic neuropathic pain, related to central sensitization states.
{"title":"Topical Phenytoin in Neuralgic Pain, Peripheral Modulation of Central Sensitization: Two Case Reports","authors":"J. Hesselink, D. Kopsky","doi":"10.4172/2167-0846.1000284","DOIUrl":"https://doi.org/10.4172/2167-0846.1000284","url":null,"abstract":"We herewith describe a topical formulation of phenytoin with a clear analgesic effect in localized neuropathic pain: in post herpetic neuralgia and trigeminal neuralgia. Such topical analgesic effect for phenytoin has not yet been described in literature. We have developed various topical phenytoin formulations and identified a stable cream base in which we compounded a range of concentrations of phenytoin up to 10%. We will present two cases supporting the analgesic effect of phenytoin cream in neuralgic pain, and discuss the putative mechanism of action of phenytoin as a topical analgesic. The essence of both cases is that, apparently, it is possible to down-regulate central sensitization processes via the modulation (inhibition) of peripheral input. This hypothesis was brought forward in 2013 based on neurophysiological data, and our clinical data seem to also support this important chapter in pain treatment. Thus, topical analgesia, in our case based on phenytoin, can play an important role in multimodal therapy of chronic neuropathic pain, related to central sensitization states.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90214364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-10DOI: 10.4172/2167-0846.1000283
S. Bajwa, Gurpreet Kaur, M. Khanna
Not many drugs in anaesthesiology have gained so much attention as ketamine got for so many years. It has been used worldwide for the last five decades through various routes and for various indications. In its early year of its manufacture, it was considered a wonder or magic drug though the popularity declined with observation of so many side effects coming to the fore through various clinical trials. However, recently its non-anaesthetic properties and anaesthetic profile has re-kindled a newer interest in its pharmacological profile. Here we stand at a new juncture where a possible confluence of its old and recent utilities can make it a drug for future thus revolutionizing its clinical usage in many scenarios. The current narrative review aims to highlight these aspects through a short journey from its pharmacological profile to its older and recent indications.
{"title":"Ketamine-The Confluence of Old and Recent Concepts","authors":"S. Bajwa, Gurpreet Kaur, M. Khanna","doi":"10.4172/2167-0846.1000283","DOIUrl":"https://doi.org/10.4172/2167-0846.1000283","url":null,"abstract":"Not many drugs in anaesthesiology have gained so much attention as ketamine got for so many years. It has \u0000 been used worldwide for the last five decades through various routes and for various indications. In its early year of \u0000 its manufacture, it was considered a wonder or magic drug though the popularity declined with observation of so \u0000 many side effects coming to the fore through various clinical trials. However, recently its non-anaesthetic properties \u0000 and anaesthetic profile has re-kindled a newer interest in its pharmacological profile. Here we stand at a new \u0000 juncture where a possible confluence of its old and recent utilities can make it a drug for future thus revolutionizing \u0000 its clinical usage in many scenarios. The current narrative review aims to highlight these aspects through a short \u0000 journey from its pharmacological profile to its older and recent indications.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77048860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4172/2167-0846.1000309
S. Sipaviciene, I. Kliziene, Jurate Pozeriene, Kristina Zaičenkovienė
Objective: This study aim was to evaluate the effects of the lumbar stabilization exercises on cross-sectional area (CSA) of the multifidus muscle, trunk muscles’ isokinetic peak torque, pain and disability in women with chronic low back pain (cLBP). Methods: The experimental group (EG; n=55) was enrolled in a 12-week lumbar stabilization exercises program. Control group (CG; n=51) did not undertake exercises. Before starting the exercise program, after completing it and 1 and 2 months after the intervention the following tests were carried out: isokinetic peak torque at an angular velocity of 60 deg/s was measured using a isokinetic dynamometer; measurement of the CSA of the multifidus muscle was performed using a ultrasound system, and patients were assessed using the Oswestry Disability Index (ODI), as well as visual analogue pain (VAS) rating scales. Results: After intervention, isokinetic peak torque (41.25% extension and 21.53% flexion) and multifidus muscle CSA (right side: 37.41 ± 0.7%; left side: 37.53 ± 0.7%) increased, VAS (44.00%) and ODI (48.74%) decreased. Conclusion: After 12-week lumbar stabilization exercises program, multifidus muscle CSA and trunk muscles peak torque increased, disability and cLBP decreased, and these changes lasted for 2 months.
{"title":"Effects of a Twelve-Week Program of Lumbar-Stabilization Exercises on Multifidus Muscles, Isokinetic Peak Torque and Pain for Women with Chronic Low Back Pain","authors":"S. Sipaviciene, I. Kliziene, Jurate Pozeriene, Kristina Zaičenkovienė","doi":"10.4172/2167-0846.1000309","DOIUrl":"https://doi.org/10.4172/2167-0846.1000309","url":null,"abstract":"Objective: This study aim was to evaluate the effects of the lumbar stabilization exercises on cross-sectional area (CSA) of the multifidus muscle, trunk muscles’ isokinetic peak torque, pain and disability in women with chronic low back pain (cLBP). Methods: The experimental group (EG; n=55) was enrolled in a 12-week lumbar stabilization exercises program. Control group (CG; n=51) did not undertake exercises. Before starting the exercise program, after completing it and 1 and 2 months after the intervention the following tests were carried out: isokinetic peak torque at an angular velocity of 60 deg/s was measured using a isokinetic dynamometer; measurement of the CSA of the multifidus muscle was performed using a ultrasound system, and patients were assessed using the Oswestry Disability Index (ODI), as well as visual analogue pain (VAS) rating scales. Results: After intervention, isokinetic peak torque (41.25% extension and 21.53% flexion) and multifidus muscle CSA (right side: 37.41 ± 0.7%; left side: 37.53 ± 0.7%) increased, VAS (44.00%) and ODI (48.74%) decreased. Conclusion: After 12-week lumbar stabilization exercises program, multifidus muscle CSA and trunk muscles peak torque increased, disability and cLBP decreased, and these changes lasted for 2 months.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"577 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87266821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4172/2167-0846.1000306
Gazi Shahinur Akter, Z. Hasan, Dur-E-Shehvar Sana, Saiful Islam Nayem, Shoriful Islam, M. Mazid
Purpose: To valuate four-quadrant location method in diagnosis and differential diagnosis of the orbital tumor by comparison study combining CT and MRI with pathology. Materials and methods: Data of 87 patients (44 female and 43 males), aged 1 to 84 years were recruited in this study, including the computed tomography(CT), Magnetic resonance imaging (MRI), and histopathology diagnosis. All orbital tumors were verified radiologically and pathologically in the Hospital of Jinggangshan University from Sep-2008 to April-2016. 49 patients underwent CT scanning (31 Conventional CT and 18 dynamic contrast enhancements CT) and 38 patients underwent MR Imaging (35 dynamic contrast enhancement MRI and 3 conventional MRI). The clinical data were retrieved from the medical record. We classified the orbital region according to four- quadrant and eight-space (FQES) division and traditional muscleconal division with center point of optic nerve. Results: Among the 87 cases of the orbital tumors, 70 cases (80.45%) were orbital benign tumors and 17 cases (19.54%) were malignant tumors. Regarding the location of the orbit, 41 lesions (47.12%) were in superolateral, 18 lesions (20.68%) were in inferolateral, 16 lesions (18.39%) were in inferomedial, 8 lesions (9.19%) were in superomedial, 3 lesions (3.44%) were in globe, 1 lesion (1.14%) was in optic nerve. The most common tumors are hemangiomas (total 36 cases: 12 in inferolateral, 8 in inferomedial, 9 in superolateral, 7 in superomedial) and 9 cases of pleomorphic adenoma were in superolateral, 9 cases of dermoid cyst ( 7 in superolateral and in 2 inferomedial), 5 cases of inflammatory pseudotumor (4 in superolateral and 1 in inferomedial), 7 cases of lymphoma (3 in superolateral, 2 in inferolateral and 2 in inferomedial ), 3 cases of adenoid cystic carcinoma in superolateral, 3 caese solitary fibrous tumor ( 2 in suprolateral and 1 in inferomedial), 3 cases lipoma (1 in superomedial, 1 in superolateral and 1 in inferolateral), 2 cases choroidal melanoma were in globe, 1 case of metastasis in superolateral, 1 case of meningioma in optic nerve, 1 case of malignant melanoma was in superolateral. The orbital tumors appeared in orbit with mostly regular, oval and rounds shape, well defined margin. The size ranged from 0.8 mm × 4.5 cm to 4.5 cm × 2.0 cm. The CT revealed iso-density in 22, slightly high–density in 15, mixed density in 6, low density in 5 and high density in 1 lesion. Among them, 18 were contrast enhancements. On T1WI image, the MRI revealed low signal intensity in 23 cases, slightly low signal in 4 cases, iso signal intensity in 7 case, high signal intensity in 3 cases, mixed signal intensity in 1 case on T2WI, it revealed high signal intensity in 23 cases, slightly high intensity in 7 cases, low signal intensity in 4 cases, iso signal intensity in 3 cases, mixed signal intensity in 1 case. Among them, 35 contrast enhancement MRI and 3 were non contrast MRI. Benign tumor was diagnosed in 70 patients, of
{"title":"Valuation of Four-Quadrant Location Method in Diagnosis and Differential Diagnosis of the Orbital Tumor by Comparison Study Combining CT and MRI with Pathology","authors":"Gazi Shahinur Akter, Z. Hasan, Dur-E-Shehvar Sana, Saiful Islam Nayem, Shoriful Islam, M. Mazid","doi":"10.4172/2167-0846.1000306","DOIUrl":"https://doi.org/10.4172/2167-0846.1000306","url":null,"abstract":"Purpose: To valuate four-quadrant location method in diagnosis and differential diagnosis of the orbital tumor by comparison study combining CT and MRI with pathology. Materials and methods: Data of 87 patients (44 female and 43 males), aged 1 to 84 years were recruited in this study, including the computed tomography(CT), Magnetic resonance imaging (MRI), and histopathology diagnosis. All orbital tumors were verified radiologically and pathologically in the Hospital of Jinggangshan University from Sep-2008 to April-2016. 49 patients underwent CT scanning (31 Conventional CT and 18 dynamic contrast enhancements CT) and 38 patients underwent MR Imaging (35 dynamic contrast enhancement MRI and 3 conventional MRI). The clinical data were retrieved from the medical record. We classified the orbital region according to four- quadrant and eight-space (FQES) division and traditional muscleconal division with center point of optic nerve. Results: Among the 87 cases of the orbital tumors, 70 cases (80.45%) were orbital benign tumors and 17 cases (19.54%) were malignant tumors. Regarding the location of the orbit, 41 lesions (47.12%) were in superolateral, 18 lesions (20.68%) were in inferolateral, 16 lesions (18.39%) were in inferomedial, 8 lesions (9.19%) were in superomedial, 3 lesions (3.44%) were in globe, 1 lesion (1.14%) was in optic nerve. The most common tumors are hemangiomas (total 36 cases: 12 in inferolateral, 8 in inferomedial, 9 in superolateral, 7 in superomedial) and 9 cases of pleomorphic adenoma were in superolateral, 9 cases of dermoid cyst ( 7 in superolateral and in 2 inferomedial), 5 cases of inflammatory pseudotumor (4 in superolateral and 1 in inferomedial), 7 cases of lymphoma (3 in superolateral, 2 in inferolateral and 2 in inferomedial ), 3 cases of adenoid cystic carcinoma in superolateral, 3 caese solitary fibrous tumor ( 2 in suprolateral and 1 in inferomedial), 3 cases lipoma (1 in superomedial, 1 in superolateral and 1 in inferolateral), 2 cases choroidal melanoma were in globe, 1 case of metastasis in superolateral, 1 case of meningioma in optic nerve, 1 case of malignant melanoma was in superolateral. The orbital tumors appeared in orbit with mostly regular, oval and rounds shape, well defined margin. The size ranged from 0.8 mm × 4.5 cm to 4.5 cm × 2.0 cm. The CT revealed iso-density in 22, slightly high–density in 15, mixed density in 6, low density in 5 and high density in 1 lesion. Among them, 18 were contrast enhancements. On T1WI image, the MRI revealed low signal intensity in 23 cases, slightly low signal in 4 cases, iso signal intensity in 7 case, high signal intensity in 3 cases, mixed signal intensity in 1 case on T2WI, it revealed high signal intensity in 23 cases, slightly high intensity in 7 cases, low signal intensity in 4 cases, iso signal intensity in 3 cases, mixed signal intensity in 1 case. Among them, 35 contrast enhancement MRI and 3 were non contrast MRI. Benign tumor was diagnosed in 70 patients, of","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"30 1","pages":"1-18"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87503520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4172/2167-0846.1000308
S. Hakata, A. Takahashi, A. Iura, Seiichi Osako, H. Uematsu, Y. Matsuda, Y. Fujino
Decreased gamma-aminobutyric acid (GABA)-mediated phasic inhibitory transmission in the spinal cord is thought to be responsible for the development of neuropathic pain. However, the role of GABAergic tonic current in substantia gelatinosa (SG) neurons remains to be fully elucidated. Using real-time polymerase chain reaction, we investigated the expression of the GABAA receptor δ subunit, which contributes to tonic current in the SG, in chronic constriction injury (CCI; a well-known model of neuropathic pain) and naive mice. The expression of the δ subunit mRNA was reduced by 40% in the ipsilateral SG of the dorsal horn of CCI mice compared to naive mice. We also performed behavioral experiments to assess the effect of the δ subunit-preferring agonist 4,5,6,7- tetrahydroisoxazolo(5,4-c)pyridine-3-ol (THIP) on thermal hypersensitivity with the Hargreaves test. Intrathecal administration of THIP significantly improved thermal thresholds of the ipsilateral hindpaw (4.55 ± 0.78 to 6.56 ± 1.09 s from baseline to after injection, respectively, P 0.1). GABAA receptor δ subunit-mediatedtonic current contributes to thermal hypersensitivity of CCI mice, and THIP may represent a therapeutic tool to improve thermal hypersensitivity.
{"title":"The Role of GABA A Receptor δ Subunit and its Agonist THIP in Thermal Hypersensitivity in a Mouse Model of Neuropathic Pain","authors":"S. Hakata, A. Takahashi, A. Iura, Seiichi Osako, H. Uematsu, Y. Matsuda, Y. Fujino","doi":"10.4172/2167-0846.1000308","DOIUrl":"https://doi.org/10.4172/2167-0846.1000308","url":null,"abstract":"Decreased gamma-aminobutyric acid (GABA)-mediated phasic inhibitory transmission in the spinal cord is thought to be responsible for the development of neuropathic pain. However, the role of GABAergic tonic current in substantia gelatinosa (SG) neurons remains to be fully elucidated. Using real-time polymerase chain reaction, we investigated the expression of the GABAA receptor δ subunit, which contributes to tonic current in the SG, in chronic constriction injury (CCI; a well-known model of neuropathic pain) and naive mice. The expression of the δ subunit mRNA was reduced by 40% in the ipsilateral SG of the dorsal horn of CCI mice compared to naive mice. We also performed behavioral experiments to assess the effect of the δ subunit-preferring agonist 4,5,6,7- tetrahydroisoxazolo(5,4-c)pyridine-3-ol (THIP) on thermal hypersensitivity with the Hargreaves test. Intrathecal administration of THIP significantly improved thermal thresholds of the ipsilateral hindpaw (4.55 ± 0.78 to 6.56 ± 1.09 s from baseline to after injection, respectively, P 0.1). GABAA receptor δ subunit-mediatedtonic current contributes to thermal hypersensitivity of CCI mice, and THIP may represent a therapeutic tool to improve thermal hypersensitivity.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"7 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87372703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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