Pub Date : 2016-10-15DOI: 10.4172/2167-0846.1000272
K. Jm
Topiceuticals can be defined as specialized pharmaceutical formulations containing topically applied drugs. Topiceutical analgesics need to be differentiated from transdermal formulations of analgesics. The latter formulations are specially designed for the active pharmaceutical ingredient to penetrate all skin structures and to generate measurable plasma levels of the formulated analgesic, such as in fentanyl plasters and topical NSAIDs. Its mechanism of actions is thus based on the systemic drug-effects and the formulations act merely as controlled release reservoirs. Topiceutical analgesics however are characterized by local analgesic effects in the absence of systemic effects, such as lidocaine and capsaicin plasters. Lidocaine and capsaicin plasters however have a number of drawbacks based on low convenience of use and local side-effects, reducing patient compliance. Topiceutical analgesics based on compounded creams should not cause such compliance issues and might become valuable new treatments for neuropathic pain. Topical compounded creams deserve a place in the modern armamentarium of the pain physician, once certain key issues such as optimal formulation and concentration are solved. We will discuss some key issues related to Topiceuticals and also present an individualized procedure to quickly differentiate responders from non-responders to topical creams. This procedure might also be helpful to evaluate efficacy and safety in a more practical way compared to full powered randomized placebo controlled trials and might expedite phase II (dose-finding) development.
{"title":"Thinking Out of the Pillbox: The Relevance to Topiceuticals in the Treatment ofNeuropathic Pain","authors":"K. Jm","doi":"10.4172/2167-0846.1000272","DOIUrl":"https://doi.org/10.4172/2167-0846.1000272","url":null,"abstract":"Topiceuticals can be defined as specialized pharmaceutical formulations containing topically applied drugs. Topiceutical analgesics need to be differentiated from transdermal formulations of analgesics. The latter formulations are specially designed for the active pharmaceutical ingredient to penetrate all skin structures and to generate measurable plasma levels of the formulated analgesic, such as in fentanyl plasters and topical NSAIDs. Its mechanism of actions is thus based on the systemic drug-effects and the formulations act merely as controlled release reservoirs. Topiceutical analgesics however are characterized by local analgesic effects in the absence of systemic effects, such as lidocaine and capsaicin plasters. Lidocaine and capsaicin plasters however have a number of drawbacks based on low convenience of use and local side-effects, reducing patient compliance. Topiceutical analgesics based on compounded creams should not cause such compliance issues and might become valuable new treatments for neuropathic pain. Topical compounded creams deserve a place in the modern armamentarium of the pain physician, once certain key issues such as optimal formulation and concentration are solved. We will discuss some key issues related to Topiceuticals and also present an individualized procedure to quickly differentiate responders from non-responders to topical creams. This procedure might also be helpful to evaluate efficacy and safety in a more practical way compared to full powered randomized placebo controlled trials and might expedite phase II (dose-finding) development.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"2013 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86298850","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 : 2016-10-10DOI: 10.4172/2167-0846.1000271
R. Berkun, Benjamin Khechen, R. Berkun
Rose Berkun1*, Benjamin Khechen1 and Ryan Berkun2 1Department of Anesthesiology, State University of New York at Buffalo, USA 2Department of Anesthesiology, University of Miami, USA *Corresponding author: Rose Berkun, Department of Anesthesiology, Jacobs School of Medicine and Biomedical Sciences President Elect, State University of New York at Buffalo, New York State, USA, Tel: 716-839-1700; E-mail: rbmd96@gmail.com
Rose Berkun1*， Benjamin Khechen1和Ryan Berkun2美国迈阿密大学麻醉系*通讯作者:Rose Berkun，麻醉系，雅各布斯医学与生物医学学院，美国纽约州布法罗市纽约州立大学候任校长，电话:716-839-1700;电子邮件:rbmd96@gmail.com
{"title":"Opioid Addiction: Addressing the Crisis of a National Opioid Overdose Epidemic","authors":"R. Berkun, Benjamin Khechen, R. Berkun","doi":"10.4172/2167-0846.1000271","DOIUrl":"https://doi.org/10.4172/2167-0846.1000271","url":null,"abstract":"Rose Berkun1*, Benjamin Khechen1 and Ryan Berkun2 1Department of Anesthesiology, State University of New York at Buffalo, USA 2Department of Anesthesiology, University of Miami, USA *Corresponding author: Rose Berkun, Department of Anesthesiology, Jacobs School of Medicine and Biomedical Sciences President Elect, State University of New York at Buffalo, New York State, USA, Tel: 716-839-1700; E-mail: rbmd96@gmail.com","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"35 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73557376","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 : 2016-09-30DOI: 10.4172/2167-0846.1000270
Upadhyay Sp, Singh Ak, M. Varma, Rao Mb, Mallick Np
Procedural sedation and analgesia is one of the common clinical practices in the emergency department. The level of sedation must be adjusted in such a way that it allows patient to tolerate unpleasant procedures while maintaining normal physiologic reflexes and consciousness and able to understand and respond to verbal or light tactile stimulus. Although drugs used for procedural sedation has wide margin of safety but inappropriate monitoring or dosing may cause serious adverse event. Procedural sedation in emergency department is not without risk. Proper monitoring; provision of readily available access to resuscitation facility and continuous presence of trained staffs capable for airway management and providing advanced life support measure contributes reduction in adverse outcome. Pre-procedural evaluation is done to screen for suitability for procedural sedation and assesses the risk factors. Patients with full stomach, difficult airway or significant medical illness requiring more than mild sedation, alternative to procedural sedation should be considered. Clinician performing procedural sedation should have through knowledge of action, dose, side effects and antidote of commonly used sedative analgesics. Newer and innovative techniques have been evolved recently including transmucosal, Tran’s nasal, inhalation anaesthetic, patient controlled sedation, target controlled sedation. All patients after procedural sedation should be monitored in a designated recovery area and should not be discharged until they meet all the discharge criteria and while sending home, proper written discharge instruction should be provided to all.
{"title":"Procedural Sedation and Analgesia in Emergency Department: A Review andUpdate","authors":"Upadhyay Sp, Singh Ak, M. Varma, Rao Mb, Mallick Np","doi":"10.4172/2167-0846.1000270","DOIUrl":"https://doi.org/10.4172/2167-0846.1000270","url":null,"abstract":"Procedural sedation and analgesia is one of the common clinical practices in the emergency department. The level of sedation must be adjusted in such a way that it allows patient to tolerate unpleasant procedures while maintaining normal physiologic reflexes and consciousness and able to understand and respond to verbal or light tactile stimulus. Although drugs used for procedural sedation has wide margin of safety but inappropriate monitoring or dosing may cause serious adverse event. Procedural sedation in emergency department is not without risk. Proper monitoring; provision of readily available access to resuscitation facility and continuous presence of trained staffs capable for airway management and providing advanced life support measure contributes reduction in adverse outcome. Pre-procedural evaluation is done to screen for suitability for procedural sedation and assesses the risk factors. Patients with full stomach, difficult airway or significant medical illness requiring more than mild sedation, alternative to procedural sedation should be considered. Clinician performing procedural sedation should have through knowledge of action, dose, side effects and antidote of commonly used sedative analgesics. Newer and innovative techniques have been evolved recently including transmucosal, Tran’s nasal, inhalation anaesthetic, patient controlled sedation, target controlled sedation. All patients after procedural sedation should be monitored in a designated recovery area and should not be discharged until they meet all the discharge criteria and while sending home, proper written discharge instruction should be provided to all.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"51 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87666255","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 : 2016-09-26DOI: 10.4172/2167-0846.1000269
N. Hendler
Chronic pain patients are misdiagnosed 40%-80% of the time, according to research from Johns Hopkins Hospital physicians. Methods to determine the validity of the complaint of pain, as well as clinical suggestions on methods to improve the accuracy of diagnosis and testing are summarized, as well as the description of an Internet based system which provides diagnoses with a 96% correlation with diagnoses of Johns Hopkins Hospital physicians.
{"title":"Evaluating chronic pain patients using methods from Johns Hopkins Hospital physicians","authors":"N. Hendler","doi":"10.4172/2167-0846.1000269","DOIUrl":"https://doi.org/10.4172/2167-0846.1000269","url":null,"abstract":"Chronic pain patients are misdiagnosed 40%-80% of the time, according to research from Johns Hopkins Hospital physicians. Methods to determine the validity of the complaint of pain, as well as clinical suggestions on methods to improve the accuracy of diagnosis and testing are summarized, as well as the description of an Internet based system which provides diagnoses with a 96% correlation with diagnoses of Johns Hopkins Hospital physicians.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"38 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89473894","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 : 2016-09-26DOI: 10.4172/2167-0846.1000268
Ekwere, R. Mercy, Udoh, E. David
Capsaicin and moisture contents of three varieties of Capsicum peppers [Capsicum frutescens- Bird eye pepper (X1) and two varieties of Capsicum annum: Chilli pepper (X2) and sweet pepper (X3)] were determined and the level of pungency related to reported observed effects on human-beings especially, as a topical analgesic. Extraction was carried out using modified method described by Kosuge et al (1958). Fractions obtained were identified as capsaicin by direct comparison with authentic samples and their ir with literature data. Every 50 g of Capsicum pepper gave mean capsaicin extracts as 0.206 ± 0.02 g (X1) and 0.066 ± 0.01 g (X2); X3, was in trace amount ( 0.05). Moisture contents was higher in two varieties- X2 (66.97 ± 0.05%) and X1 (51.57 ± 0.03%); X3 had the lowest moisture content of 43.19 ± 0.01% suggesting that moisture content and not size affects the level of pungency contrary to popular believe that the bigger pepper are, the hotter. Bird-eye and chilli peppers, with high capsaicin content, would have medicinal values as topical analgesic.
测定了三种辣椒品种(红椒-鸟眼椒(X1)和两种辣椒品种:红辣椒(X2)和甜椒(X3))的辣椒素和水分含量，其辛辣程度与报道观察到的对人类的影响有关，特别是作为局部镇痛药。提取方法采用Kosuge et al(1958)的改进方法。通过与真实样品的直接比较，并与文献数据进行比较，鉴定出所得馏分为辣椒素。每50 g辣椒平均辣椒素提取量为0.206±0.02 g (X1)和0.066±0.01 g (X2);X3为微量(0.05)。水分含量较高的两个品种X2(66.97±0.05%)和X1(51.57±0.03%);X3的水分含量最低，为43.19±0.01%，说明影响辣椒辣度的是水分含量，而不是辣椒大小，这与人们普遍认为的辣椒越大越辣不同。鸟眼辣椒和红辣椒具有较高的辣椒素含量，具有局部镇痛的药用价值。
{"title":"Extraction and Comparative Analysis of Moisture and Capsaicin Contents of Capsicum Peppers","authors":"Ekwere, R. Mercy, Udoh, E. David","doi":"10.4172/2167-0846.1000268","DOIUrl":"https://doi.org/10.4172/2167-0846.1000268","url":null,"abstract":"Capsaicin and moisture contents of three varieties of Capsicum peppers [Capsicum frutescens- Bird eye pepper (X1) and two varieties of Capsicum annum: Chilli pepper (X2) and sweet pepper (X3)] were determined and the level of pungency related to reported observed effects on human-beings especially, as a topical analgesic. Extraction was carried out using modified method described by Kosuge et al (1958). Fractions obtained were identified as capsaicin by direct comparison with authentic samples and their ir with literature data. Every 50 g of Capsicum pepper gave mean capsaicin extracts as 0.206 ± 0.02 g (X1) and 0.066 ± 0.01 g (X2); X3, was in trace amount ( 0.05). Moisture contents was higher in two varieties- X2 (66.97 ± 0.05%) and X1 (51.57 ± 0.03%); X3 had the lowest moisture content of 43.19 ± 0.01% suggesting that moisture content and not size affects the level of pungency contrary to popular believe that the bigger pepper are, the hotter. Bird-eye and chilli peppers, with high capsaicin content, would have medicinal values as topical analgesic.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"12 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2016-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78171628","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 : 2016-09-24DOI: 10.4172/2167-0846.1000266
G. Tanaka, M. Almeidade, P. Ribeiro, B. Velasques
Guaraci Ken Tanaka1,2, Almeida de M1, Ribeiro P2,3,4 and Velasques B1,2,3,4* 1Department of Neurophysiology and Neuropsychology, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Brazil 2Institute of Applied Neuroscience (INA), Rio de Janeiro, Brazil 3Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Brazil 4Department of Bioscience, School of Physical Education of the Federal University of Rio de Janeiro (UFRJ), Brazil *Corresponding author: Velasques B, Department of Neurophysiology and Neuropsychology, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/ UFRJ), Brazil, Tel: 55-2199-4454996; E-mail: bruna_velasques@yahoo.com.br
Guaraci Ken Tanaka1,2, Almeida de M1, Ribeiro P2,3,4 and Velasques B1,2,3,4* 1巴西里约热内卢联邦大学精神病学研究所(IPUB/UFRJ)神经生理与神经心理学系2巴西里约热内卢应用神经科学研究所(INA) 3巴西里约热内卢联邦大学精神病学研究所(IPUB/UFRJ)脑映射与感觉运动整合4生物科学系通讯作者:Velasques B，里约热内卢联邦大学精神病学研究所神经生理与神经心理学系(IPUB/ UFRJ)，巴西，电话:55-2199-4454996;电子邮件:bruna_velasques@yahoo.com.br
{"title":"Neuroscientific Changes of Chronic Neuropathic Pain: A Brief Comment on Evidence-Based Practice","authors":"G. Tanaka, M. Almeidade, P. Ribeiro, B. Velasques","doi":"10.4172/2167-0846.1000266","DOIUrl":"https://doi.org/10.4172/2167-0846.1000266","url":null,"abstract":"Guaraci Ken Tanaka1,2, Almeida de M1, Ribeiro P2,3,4 and Velasques B1,2,3,4* 1Department of Neurophysiology and Neuropsychology, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Brazil 2Institute of Applied Neuroscience (INA), Rio de Janeiro, Brazil 3Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Brazil 4Department of Bioscience, School of Physical Education of the Federal University of Rio de Janeiro (UFRJ), Brazil *Corresponding author: Velasques B, Department of Neurophysiology and Neuropsychology, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/ UFRJ), Brazil, Tel: 55-2199-4454996; E-mail: bruna_velasques@yahoo.com.br","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"20 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75587861","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 : 2016-09-23DOI: 10.4172/2167-0846.1000265
S. Patel
1. Bayol SA, Macharia R, Farrington SJ, Simbi BH, Stickland NC (2009) Evidence that a maternal junk food diet during pregnancy and lactation can reduce muscle force in offspring. Eur J Nutr 48: 62-65. 2. McDonald LJ, Bhatia RS, Hollett PD (2002) Deposition of cigar smoke particles in the lung: evaluation with ventilation scan using (99 m) Tclabeled sulfur colloid particles. J Nucl Med 43: 1591–1595. 3. Nikam PH, Jadhav A, Kadam V, Kareparamban J (2012) Future trends in standardization of herbal drugs. J of Applied Pharmaceutical Sci 2: 38-44 4. Izzo AA, Ernst E (2009)Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 69: 1777-1798. Patel, J Pain Relief 2016, 5:5 DOI: 10.4172/2167-0846.1000265
{"title":"Today’s Problem is Pain at the End of the Day and also with the Beginning of the Day","authors":"S. Patel","doi":"10.4172/2167-0846.1000265","DOIUrl":"https://doi.org/10.4172/2167-0846.1000265","url":null,"abstract":"1. Bayol SA, Macharia R, Farrington SJ, Simbi BH, Stickland NC (2009) Evidence that a maternal junk food diet during pregnancy and lactation can reduce muscle force in offspring. Eur J Nutr 48: 62-65. 2. McDonald LJ, Bhatia RS, Hollett PD (2002) Deposition of cigar smoke particles in the lung: evaluation with ventilation scan using (99 m) Tclabeled sulfur colloid particles. J Nucl Med 43: 1591–1595. 3. Nikam PH, Jadhav A, Kadam V, Kareparamban J (2012) Future trends in standardization of herbal drugs. J of Applied Pharmaceutical Sci 2: 38-44 4. Izzo AA, Ernst E (2009)Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 69: 1777-1798. Patel, J Pain Relief 2016, 5:5 DOI: 10.4172/2167-0846.1000265","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"515 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2016-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77097677","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 : 2016-09-22DOI: 10.4172/2167-0846.1000263
Hao Zhang, Pengcheng Ye, Yinglin Wang, Qingxiu Wang
Background: Surgery is usually the first treatment for breast cancer which is followed by some complications such as chronic pain. Post mastectomy pain syndrome (PMPS) is a common complication among breast cancer survivors and is considered as a chronic neuropathic pain in the side of surgery which persists more than six months. The exact mechanisms and related risk factors of the chronic pain after breast surgery are unknown. The aim of this study is to investigate the epidemiological characteristics of postoperative pain syndrome in Chinese breast cancer patients, and to analyze the related risk factors. Methods: A prospective cohort study of 202 female breast cancer patients undergoing elective breast surgery for a period of 6 months follow-up survey. The incidence rate of pain in patients with chronic pain was assessed by the self-rating scale of ID. Pain and 16 related risk factors were statistically analyzed. Results: A prospective cohort study of 202 female breast cancer patients undergoing elective breast surgery for a period of 6 months follow-up survey. The incidence rate of pain in patients with chronic pain was assessed by the self-rating scale of ID. Pain and 16 related risk factors were statistically analyzed. Conclusions: PMPS occupies a certain proportion in breast cancer patients after surgery. Age and psychological abnormalities associated with preoperative breast cancer patients may undergo PMPS. It is possible to have a certain significance to choose the operation mode of the trauma, the psychological intervention before the operation and the management of the acute pain after the operation to prevent the PMPS.
{"title":"Prospective Study of Postoperative Pain Syndrome in Patients with BreastCancer and its Related Factors","authors":"Hao Zhang, Pengcheng Ye, Yinglin Wang, Qingxiu Wang","doi":"10.4172/2167-0846.1000263","DOIUrl":"https://doi.org/10.4172/2167-0846.1000263","url":null,"abstract":"Background: Surgery is usually the first treatment for breast cancer which is followed by some complications such as chronic pain. Post mastectomy pain syndrome (PMPS) is a common complication among breast cancer survivors and is considered as a chronic neuropathic pain in the side of surgery which persists more than six months. The exact mechanisms and related risk factors of the chronic pain after breast surgery are unknown. The aim of this study is to investigate the epidemiological characteristics of postoperative pain syndrome in Chinese breast cancer patients, and to analyze the related risk factors. Methods: A prospective cohort study of 202 female breast cancer patients undergoing elective breast surgery for a period of 6 months follow-up survey. The incidence rate of pain in patients with chronic pain was assessed by the self-rating scale of ID. Pain and 16 related risk factors were statistically analyzed. Results: A prospective cohort study of 202 female breast cancer patients undergoing elective breast surgery for a period of 6 months follow-up survey. The incidence rate of pain in patients with chronic pain was assessed by the self-rating scale of ID. Pain and 16 related risk factors were statistically analyzed. Conclusions: PMPS occupies a certain proportion in breast cancer patients after surgery. Age and psychological abnormalities associated with preoperative breast cancer patients may undergo PMPS. It is possible to have a certain significance to choose the operation mode of the trauma, the psychological intervention before the operation and the management of the acute pain after the operation to prevent the PMPS.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"19 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78967107","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 : 2016-09-22DOI: 10.4172/2167-0846.1000264
D. Jasińska, Jerzy Boczon
We present the case of a 35 year old patient who suffered from the chronic widespread pain that mimicked fibromyalgia or myopathy, and turned out to be an acquired endocrinological disorder. The Patient was previously treated for fungal skin infection and had been taking terbinafine for 3 months and developed testis and adrenal gland insufficiency.
{"title":"Post Terbinafine Adrenal Gland and Testis Dysfunction that ImitatedFibromyalgia: Case Report","authors":"D. Jasińska, Jerzy Boczon","doi":"10.4172/2167-0846.1000264","DOIUrl":"https://doi.org/10.4172/2167-0846.1000264","url":null,"abstract":"We present the case of a 35 year old patient who suffered from the chronic widespread pain that mimicked fibromyalgia or myopathy, and turned out to be an acquired endocrinological disorder. The Patient was previously treated for fungal skin infection and had been taking terbinafine for 3 months and developed testis and adrenal gland insufficiency.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"73 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76551396","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 : 2016-09-19DOI: 10.4172/2167-0846.1000262
JoÃo Gustavo Dos Santos, K. Duarte, M. Teixeira
Introduction: In 1953, Luft and Olivecrona described surgical ablation of the pituitary gland in the treatment of metastases from hormone-dependent tumors, with a view to reduce the spread of the disease rather than specifically for analgesia. The mechanism of hypophysectomy remains uncertain, but it has been suggested that part of the effect may be a result of the spread of physical-chemical agent through the pituitary stalk into the hypothalamus, thereby directly causing fixation, or indirectly causing thrombosis and infarction. The possibility of treating the pain in independent-hormonal tumors was tested, and presented satisfactory results. Based on that, we performed a stereotaxic transsphenoidal hypophysectomy by radiofrequency in a palliative patient. Case Report: 54 year-old female patient, who was a smoker. In december, 2015, she started presenting dorsal back pain, radiating to the lower back, hip and medial thighs bilaterally, in distress, continuous, progressive, without triggering factors for worsening or improvement, which got worse on palpation. In March 2016, she was investigated at Hospital das Clinicas, School of Medicine, USP. Computed tomography of chest, abdomen and pelvis (03/14/2016): Multiple osteolytic lesions, lung mass in the left lower lobe base of 4.7 cm, diffuse injury in thoracic, lumbar and sacral-iliac spine. Iliac Biopsy (03/15/2016): mucinous adenocarcinoma. After staging, Oncology opted for palliative treatment. Pain treatment showed unsatisfactory analgesia. Due to that, it was proposed stereotactic transsphenoidal hypophysectomy by radiofrequency. Procedure was performed in April 14th, 2016, uneventfully Patient had considerable improvement in bone pain in the immediate postoperative day (VAS=0), getting back to walking. She kept hospitalizated until the fourth postoperative day. She was discharged on April 18th, 2016. Conclusion: The procedure rises as an interesting option for refractory metastatic bone pain, presenting the advantage of fast resolution of intense pain and low rate of complications, diminishing hospitalization days, which is a fundamental aspect to be observed in these palliative patients
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