- Topical pimecrolimus versus betamethasone for oral lichen planus: a randomized clinical trial. [Journal Article]
- COClin Oral Investig 2018 Jun 16
- CONCLUSIONS: Pimecrolimus showed earlier clinical response and less recurrence rate compared with standard topical corticosteroid in symptomatic OLP lesions, and both treatment reduced CD133-positive CSC population.The study proved the benefits of topical pimecrolimus in early management of painful lesions of OLP and its ability to inhibit CSCs, suggesting a possible role in reducing risk of malignant transformation.
- Spinal SHP2 contributes to exaggerated incisional pain in adult rats subjected to neonatal and adult incisions via PI3K. [Journal Article]
- NNeuroscience 2018 Jun 14
- Neonatal injury-induced exaggeration of pain hypersensitivity after adult trauma is a significant clinical challenge. However, the underlying mechanisms remain poorly understood. Growing evidence sho...
Neonatal injury-induced exaggeration of pain hypersensitivity after adult trauma is a significant clinical challenge. However, the underlying mechanisms remain poorly understood. Growing evidence shows that spinal Src homology-2 domain-containing protein tyrosine phosphatase-2 (SHP2) contributes to chronic pain in adult rodents. Here we demonstrated that the phosphorylation and expression of SHP2 in synaptosomal fraction of the spinal dorsal horn are elevated in adult rats subjected to neonatal and adult incisions (nIN-IN), and the upregulation of SHP2 is highly correlated with pain hypersensitivity. Intrathecal blockade of SHP2 phosphorylation using a SHP2 protein tyrosine phosphatase inhibitor NSC-87877, or knockdown of SHP2 by intrathecal delivery of small interfering RNA (siRNA), ameliorates mechanical allodynia and heat hyperalgesia in nIN-IN rats. Moreover, the expression of phosphatidylinositol 3-kinase (PI3K) in the spinal dorsal horn is significantly increased in nIN-IN rats. Intrathecal application of PI3K inhibitor, LY294002 or wortmannin, alleviates pain hypersensitivity in nIN-IN rats. Additionally, intrathecal administration of NSC-87877 or SHP2 siRNA attenuates the upregulation of PI3K. Finally, no alternation of SHP2 phosphorylation in the dorsal root ganglion and dorsal root of nIN-IN rats as well as PI3K expression in the dorsal root of nIN-IN rats intrathecally treated with NSC-87877 or SHP2 siRNA is observed. These results suggest that the phosphorylation and expression of SHP2 in the spinal dorsal horn play vital roles in neonatal incision-induced exaggeration of adult incisional pain via PI3K. Thus, SHP2 and PI3K may serve as potential therapeutic targets for exaggerated incisional pain induced by neonatal and adult injuries.
- Congenital Partial Aplasia of the Atlas Causing Functional Angular Displacement of the Posterior Arch. [Journal Article]
- PM RPM R 2018 Jun 14
- Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis. [Journal Article]
- JPJ Physiother 2018 Jun 13
- CONCLUSIONS: This review found moderate-quality evidence supporting the effectiveness of an exercise program for reducing the risk of a new episode of neck pain. There is a need for high-quality randomised, controlled trials evaluating interventions to prevent new episodes of neck pain.
- A rare case of type 1 leprosy reactions following tetanus infection in a borderline tuberculoid leprosy patient and a literature review. [Journal Article]
- IDInfect Dis Poverty 2018 Jun 17; 7(1):58
- CONCLUSIONS: This report suggests that tetanus infection may be a trigger for type 1 leprosy reactions.
- Clinical reasoning in unimodal interventions in patients with non-specific neck pain in daily physiotherapy practice, a Delphi study. [Journal Article]
- MSMusculoskelet Sci Pract 2018 Jun 02; 37:8-16
- CONCLUSIONS: Pain alone is not an indication for physiotherapy. Insight has been obtained into which measurement instruments are used and when they are used. Consensus about sequential linear lines of clinical reasoning was poor.
- Cervical Sympathetic Chain Schwannoma Masquerading as a Vagus Nerve Schwannoma Complicated by Postoperative Horner's Syndrome and Facial Pain: A Case Report. [Journal Article]
- IJInt J Surg Case Rep 2018 Jun 09; 49:4-7
- CONCLUSIONS: Studies indicate that imaging trends used for distinction between VNS and CSCS show inconsistencies in making preoperative diagnoses. Recent literature reveals helpful criteria for improving diagnostic standards that assist with preoperative patient counseling. In addition, postoperative outcomes, such as temporary, asymptomatic Horner's syndrome are common in CSCS. The following case report exemplifies the difficulties in diagnosis and addresses the unique complications of facial pain and permanent Horner's syndrome.This case report examines postoperative outcomes and improves clinician awareness of the potential for misdiagnosis of a rare neoplasm and the recently improved diagnostic measures, providing for higher quality preoperative counseling. Future research is recommended to confirm and improve diagnostic guidelines and accuracy. Additional studies may focus on evaluating the effects of incorrect preoperative diagnosis on postoperative complication rates.
- Anatomical Variants Of The Paranasal Sinuses In Patients With Mid-facial Segment Pain: Our Experience Of A Cohort Of Twenty-Three Patients. [Journal Article]
- COClin Otolaryngol 2018 Jun 16
- Facial pain is not an uncommon reason for referral to an otolaryngologist, frequently misdiagnosed as sinusitis by primary care professional. However, many of these 'sinus headache' patients do not h...
Facial pain is not an uncommon reason for referral to an otolaryngologist, frequently misdiagnosed as sinusitis by primary care professional. However, many of these 'sinus headache' patients do not have concomitant clinical symptoms suggestive of sinus infection such as purulent discharge or pyrexia . Most actually suffer from non-sinugenic facial pain conditions such as atypical migraine or tension headache . This article is protected by copyright. All rights reserved.
- Improvised first aid techniques for terrorist attacks. [Editorial]
- EMEmerg Med J 2018 Jun 15
- Terrorist acts occur every day around the world. Healthcare professionals are often present as bystander survivors in these situations, with none of the equipment or infrastructure they rely on in th...
Terrorist acts occur every day around the world. Healthcare professionals are often present as bystander survivors in these situations, with none of the equipment or infrastructure they rely on in their day-to-day practice. Within several countries there has been a move to disseminate the actions to take in the event of such attacks: in the UK, Run, Hide, Tell, and in the USA, Fight Back This paper outlines how a very basic medical knowledge combined with everyday high-street items can render highly effective first aid and save lives. We discuss and summarise modern improvised techniques. These include the <C> ABCDE approach of treating catastrophic haemorrhage before airway management, bringing together improvised techniques from the military and wilderness medicine. We explain how improvised tourniquets, wound dressings, splinting and traction devices can be fabricated using items from the high street: nappies, tampons, cling film, duct tape and tablecloths. Cervical spine immobilisation is a labour-intensive protocol that is often practised defensively. With little evidence to support the routine use of triple immobilisation, this should be replaced with a common sense dynamic approach such as the Montana neck brace. Acid or alkali attacks are also examined with simple pragmatic advice. Analgesia is discussed in the context of a prehospital setting. Pharmacy-obtained oral morphine and diclofenac suppositories can be used to treat moderate pain without relying on equipment for intravenous/intraosseous infusion in prolonged hold situations. The differentiation between concealment and cover is summarised: scene safety remains paramount.
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- The impact of mental health on patient-reported outcomes in cervical radiculopathy or myelopathy surgery. [Journal Article]
- JCJ Clin Neurosci 2018 Jun 12
- Optimizing functional outcomes and disability status are essential for effective surgical treatment of cervical spine disorders. Mental impairment is common among patients with cervical spine complai...
Optimizing functional outcomes and disability status are essential for effective surgical treatment of cervical spine disorders. Mental impairment is common among patients with cervical spine complaints; yet little is known about the impact of baseline mental status with respect to overall patient-reported outcomes. This was a retrospective analysis of patients with cervical spondylosis with myelopathy(CM) or radiculopathy(CR: cervical disc herniation, stenosis, or spondylosis without myelopathy) at 2-year follow-ups. Patients were assessed for several health-related quality of life HRQOL) measures at baseline and 24-months post-operatively: Neck Disability Index (NDI), Visual Analog Scale(VAS), Short Form-36(SF) Physical(PCS) and Mental(MCS) Components. Patients were dichotomized by MCS score: LOW-MCS(SF-MCS < 40th percentile) vs. HIGH-MCS(SF-MCS > 60th percentile). Independent and paired t-tests compared improvement in each group for HIGH-MCS and LOW-MCS cohorts. 375 patients were analyzed(65.4yrs, 67.6%F). LOW-MCS radiculopathy patients showed significant improvement in NDI, VAS Neck and Arm Pain(p < 0.05). HIGH-MCS radiculopathy patients showed greater improvement in NDI score, VAS Neck and Arm Pain, and improvement in PCS(all p < 0.05). Comparing baseline and 2-year follow-up, LOW-MCS CM patients showed significant improvement in PCS, NDI, VAS Neck and Arm Pain(p < 0.05). HIGH-MCS myelopathy patients group showed marked improvement in NDI scores, VAS Neck and Arm Pain(p < 0.05). LOW-MCS CR patients were more likely to be less satisfied 2-years post-op(p < 0.001). Postoperative CR patients with lower baseline mental status saw less improvement and significantly worse outcomes than patients with higher baseline mental status. Improving baseline mental health may improve post-operative recovery. Implementing additional screening and care can optimize functional outcomes and disability status for patients with CR.