scholarly journals Improvement of bone-erosive temporomandibular joint (TMJ) abnormalities in adolescents undergoing non-surgical treatment: a longitudinal study

2020 ◽  
Vol 49 (5) ◽  
pp. 20190338 ◽  
Author(s):  
Anna-Karin Abrahamsson ◽  
Linda Z Arvidsson ◽  
Milada Cvancarova Småstuen ◽  
Tore A Larheim
Keyword(s):  
Chronic Pain ◽  
Temporomandibular Joint ◽  
Cone Beam Ct ◽  
Functional Limitation ◽  
Young Patients ◽  
Pain Scale ◽  
Imaging Characteristics ◽  
Surgical Methods ◽  
Patient Series

Objectives: To investigate the longitudinal changes of the imaging temporomandibular joint (TMJ) characteristics in young patients with TMJ-related symptoms and treated with non-surgical methods. The severity of self-reported symptoms at follow-up was also investigated. Methods: A cone beam CT (CBCT)/CT follow-up examination [median follow-up 4.1 (1.3–6.4) years] was performed in 22 patients with erosive TMJ abnormalities [baseline median age 16 (12–18) years]. Imaging characteristics were analyzed and the changes between the examinations were categorized as (A) improvement, (B) no change, or (C) worsening. Severity of follow-up symptoms was evaluated using Jaw Functional Limitation Scale (JFLS-8) and Graded Chronic Pain Scale (Grade 0–IV). Analyses were performed separately for left and right TMJ. Findings at baseline and follow-up were compared using McNemar test to account for dependencies. Changes in proportions of hard tissue findings between examinations were assessed using Wilcoxon signed ranks test. Results: A significant reduction in the proportion of patients with erosive abnormalities was found [59.1%, 95% CI (36.4–79.3) %]. Baseline erosions improved in 9/12 (75%) right and 14/15 (93%) left TMJs. About half repaired; developed an intact cortical outline. Number of joints with osteophytes increased (right: p < 0.04, left: p < 0.003). New osteophytes were mostly found in joints with erosive findings. Low or no limitation of jaw function (Jaw Functional Limitation Scale) was found in 12/22 (55%) and no or low intensity of pain (Graded Chronic Pain Scale Grade 0 or I) in 19/22 (86%) at follow-up. Conclusion: We found a high potential for repair of erosive TMJ abnormalities. However, the patient series was small. The majority of patients assessed their symptom severity at follow-up as low.

scholarly journals Management of temporomandibular joint recurrent dislocation using Dautery’s procedure: report and review

2019 ◽  
Vol 5 (6) ◽  
pp. 1748
Author(s):  
S. K. Bhandari ◽  
Yuvraj Issar ◽  
Shanender Singh Sambyal ◽  
Andrews Navin Kumar
Keyword(s):  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Recurrent Dislocation ◽  
Anterior Dislocation ◽  
Articular Eminence ◽  
Forward Movement ◽  
Tmj Dislocation ◽  
Surgical Methods ◽  
One Year

<p class="abstract">Temporomandibular joint (TMJ) dislocation is an involuntary forward movement of the mandible beyond the articular eminence with the condyle remaining stuck in the anterior-most position which leaves the patient unable to close his mouth. Various surgical methods have been described in literature for the management of TMJ dislocation in patients where conservative measures are not successful and need surgical intervention. This case report highlights outcome of Dautrey’s method of surgical correction in three cases of recurrent bilateral TMJ dislocation. All the patients had history of manual reduction of lock jaw in the past and none was medically compromised. TMJ tomograms open mouth confirmed anterior dislocation of condyles beyond articular eminence in all three patients. Total six Dautrey’s procedures were performed. All the patients showed marked improvement in pain and TMJ function with no relapse at two years follow up. Post-operative mouth opening became normal in all the patients at one year follow up. No episode of pain, clicking, deviation or TMJ dislocation was seen in follow up period of 1, 3, 6, 12, 24 months. Hence, Dautery’s procedure serves as an effective management option for recurrent temporomandibular joint dislocation.</p>

scholarly journals Neutralized Chemical Matricectomy with the Winograd Method in the Management of Ingrowing Toenail

2014 ◽  
Vol 1 (2) ◽  
pp. 55-59
Author(s):  
Sanjay Agarwala ◽  
Anshul Shyam Sobti ◽  
Ganesh Mohrir
Keyword(s):  
Functional Limitation ◽  
Normal Activity ◽  
Deep Infection ◽  
Postoperative Recovery ◽  
Asia Pacific ◽  
Average Return ◽  
Surgical Methods ◽  
Good Cosmetic ◽  
High Level

ABSTRACT Background Ingrowing toenail is a common condition provoking pain, inflammation and functional limitation. Many surgical methods have evolved over the years for its treatment. The most important aspect of treatment of this problem is to prevent recurrence. The purpose of this paper was to study the effectiveness of combining the standard Winograd technique with neutralized chemical matricectomy to reduce the chances of recurrence and expedite postoperative recovery. Materials and methods Between 2006 and 2013, 33 patients (18 males, 15 females); with mean age 37.39 years (range 16 to 65 years) with 38 ingrowing toenails were treated with the standard Winograd technique combined with phenol matricectomy. The patients were evaluated in subsequent follow-ups for postoperative relapse, pain score (VAS) and time return to daily activities and ability to wear footwear and overall satisfaction. The mean follow-up period was 3.57 years (range 2 to 7 years). Results A total of 94.73% patients were satisfied with the overall outcome. The average return to normal shoe-wear was 1.54 weeks and the average return to normal activity was 1.18 weeks. Recurrence was seen in two patients (5.26%), 5 and 6 months after surgery. Four patients had delayed healing. None of the patients had any deep infection or neurovascular complications. Conclusion The Winograd technique when combined with neutralized phenol matricectomy is associated with a very low recurrence and infection rate. It allows early postoperative recovery and good cosmetic results with a high level of patient satisfaction. How to cite this article Agarwala S, Sobti AS, Mohrir G. Neutralized Chemical Matricectomy with the Winograd Method in the Management of Ingrowing Toenail. J Foot Ankle Surg (Asia-Pacific) 2014;1(2):55-59.

Pain Characteristics, Cardiovascular Risk Factors, and Cardiovascular Disease

2021 ◽  
Author(s):  
Isabel Rodríguez-Sánchez ◽  
Rosario Ortolá ◽  
Auxiliadora Graciani ◽  
David Martínez-Gómez ◽  
Jose R Banegas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Pain ◽  
Diet Quality ◽  
Pain Scale ◽  
Cvd Risk Factors ◽  
Recreational Physical Activity ◽  
Cvd Risk

Abstract Background There is unclear evidence that chronic pain may increase the risk of cardiovascular disease (CVD) incidence and mortality. This work evaluated the association between chronic pain, incidence of CVD and changes in CVD risk factors. Methods Cohort of 1091 community-dwelling individuals ≥60years, free from CVD at baseline, followed up for 6 years. Data on psychosocial factors and CVD risk factors was obtained through validated questionnaires and laboratory measurements. A pain scale ranging from 0 (no pain) to 6 (worst pain) was created according to pain frequency, location and intensity. Results The cumulative incidence of CVD was 4.2% at 3 years, and 7.7% at 5-years of follow-up. Compared to individuals without pain in the first 3 years (2012-2015), those with maintained scores ≥2 showed a mean reduction of 3.57 (-5.77,-1.37) METs-h/week in recreational physical activity; a 0.38-point (0.04,0.73) increase in psychological distress; and a 1.79 (1.03,3.11) higher odds of poor sleep. These associations held in the second follow-up period, when individuals with maintained pain also worsened their diet quality. A 1-point increase in the pain scale in 2012 was associated with a 1.21 (1.03,1.42) and 1.18 (0.97,1.44) increased CVD incidence in 2015 and 2017, respectively; none of the studied factors mediated this relationship. Conclusions Older adults with chronic pain show important reductions in recreational physical activity and deterioration in mental health, sleep and diet quality, which may well aggravate pain. Future studies should evaluate whether these factors mediate the increased risk of CVD observed in older adults with chronic pain.

scholarly journals Lymphatic Venous Anastomosis Can Release the Lymphedema-Associated Pain of Upper Limb after Breast Cancer Treatment

2018 ◽  
Vol 03 (01) ◽  
pp. e1-e7 ◽  
Author(s):  
Makoto Mihara ◽  
Hisako Hara ◽  
Han Zhou ◽  
Shuichi Tange ◽  
Kazuki Kikuchi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Chronic Pain ◽  
Cancer Treatment ◽  
Upper Limb ◽  
Pain Scale ◽  
Breast Cancer Treatment ◽  
Venous Anastomosis ◽  
Before And After ◽  
Vas Scores

Background Sometimes, chronic pain in the arm or chest could occur in postmastectomy patients. Although the pathology of the pain is unclear, the involvement of neurological mechanism, cicatricial contracture, or lymphedema is considered. The purpose of this study was to investigate the effectiveness of lymphaticovenous anastomosis (LVA) in reducing chronic pain in upper limb lymphedema patients. Patients and Methods This prospective study included consecutive 13 patients with upper limb lymphedema who received LVA. Preoperative lymphoscintigraphy and indocyanine green lymphography were performed. Pre- and postoperative pain scale were recorded using the visual analog scale (VAS). The number of cellulitis 1 year before and after LVA were compared. LVA was performed under local anesthesia, using a surgical microscope, and 12–0 nylon suture was used in the anastomosis. Results Two out of 13 patients were excluded from this study, and 11 patients were subjected to this study. All subjects were females with an average age of 64.3 years. The average lymphedema duration was 76.7 months. The average number of LVA sites was 5.7 per limb and the average follow-up period was 10.6 months. The average pre- and postoperative VAS scores were 3.5 and 0.59, respectively; the significant decrease was observed (p = 0.017). Three of the patients who had experienced cellulitis (once, twice, and four times, respectively) did not develop any cellulitis after LVA. Conclusion LVA was shown to be an effective surgical remedy for treating the lymphedema-associated pain of upper limb after breast cancer treatment.

Spinal and Nucleus Caudalis Dorsal Root Entry Zone Operations for Chronic Pain

2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONS235-ONS244 ◽  
Author(s):  
Yucel Kanpolat ◽  
Hakan Tuna ◽  
Melih Bozkurt ◽  
Atilla Halil Elhan
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Dorsal Root ◽  
Intractable Pain ◽  
Entry Zone ◽  
Dorsal Root Entry Zone ◽  
Root Entry Zone ◽  
Surgical Methods ◽  
Cord Injury

Abstract Objective: Dorsal root entry zone (DREZ) operations came into medical practice after the demonstration of increased electrical activity in the dorsal horn of the spinal cord and brainstem in patients with deafferentation of the central nervous system after injury to these areas. The aim of the study was to describe the technique and the effectiveness of spinal DREZ and nucleus caudalis (NC) DREZ operations, which may be the treatments of choice in unique chronic pain conditions that do not respond to medical therapy or any other surgical methods. Methods: Fifty-five patients (44 spinal, 11 NC DREZ) underwent 59 (48 spinal, 11 NC DREZ) operations. There were 44 men and 11 women with a mean age of 46.4 years (range, 24–74 yr). The mean follow-up period was 72 months (range, 6 mo–20 yr). Follow-up assessments were performed with clinical examination on the first day and in the sixth and twelfth months postoperatively. Patients' pain scores and Karnofsky Performance Scale scores were also evaluated pre- and postoperatively. Results: The initial success rates for spinal and NC DREZotomy procedures were 77 and 72.5%, respectively. In the spinal DREZotomy group, mortality occurred in one patient (2.2%). There were two cases of transient muscle weakness (4.4%) and two of cerebrospinal fluid fistulae (4.4%). In the NC DREZotomy group, mortality occurred in one patient (9%). There were two cases of transient ataxia (18%) and two of transient hemiparesis (18%). Conclusion: Spinal and trigeminal NC DREZ operations are effective in the treatment of intractable pain syndromes, especially in traumatic brachial plexus avulsions, segmental pain after spinal cord injury, postherpetic neuralgia, topographically limited cancer pain, and atypical facial pain.

Treatment Expectations in Chronic Pain Scale

2019 ◽  
Author(s):  
M. Gabrielle Pagé ◽  
Daniel Ziemianski ◽  
Marc Olivier Marte ◽  
Yoram Shir
Keyword(s):  
Chronic Pain ◽  
Pain Scale ◽  
Treatment Expectations

Rezidivrisiko nach thyreostatischer Behandlung immunogener und nicht-immunogener Hyperthyreosen

1990 ◽  
Vol 29 (01) ◽  
pp. 1-6 ◽  
Author(s):  
E. Voth ◽  
N. Dickmann ◽  
H. Schicha ◽  
D. Emrich
Keyword(s):  
Relapse Rate ◽  
Urinary Iodine ◽  
Young Patients ◽  
Antithyroid Drugs ◽  
Urinary Iodine Excretion ◽  
Old Patients ◽  
Primary Disease ◽  
Iodine Excretion ◽  
Immunogenic Hyperthyroidism

Data of 196 patients treated for hyperthyroidism exclusively with antithyroid drugs were analyzed retrospectively concerning the relapse rate within a follow-up period of four years. Patients were subdivided for primary or recurrent disease, and for immunogenic or non-immunogenic hyperthyroidism, respectively. In immunogenic as well as in non-immunogeriic hyperthyroidism, the relapse rate was significantly lower for patients with primary disease (35% and 52%, respectively) compared to those with recurrent hyperthyroidism (82%, p <0.001 and 83%, p <0.001, respectively). In patients with primary disease, clinical, biochemical and scintigraphic parameters were tested with respect to their capability of predicting a relapse. For immunogenic hyperthyroidism the highest relapse rates were observed in young patients and in those with large goitres, whereas for non-immunogenic hyperthyroidism they were highest in old patients, in those with nodular goitres and in those without an increased urinary iodine excretion at the time of diagnosing hyperthyroidism.

Standardized Tendon Fenestration with Injection of Autologous Blood for Treatment of Lateral Epicondylitis

2020 ◽  
Author(s):  
Chul Ki Goorens ◽  
Pascal Wernaers ◽  
Joost Dewaele
Keyword(s):  
Tennis Elbow ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Pain Scale ◽  
Short Term ◽  
Shockwave Therapy ◽  
Other Substances ◽  
Injured Tendon ◽  
Satisfaction Rates

AbstractLateral epicondylitis (LE) of the elbow is often treated with conservative methods. Several techniques including injections with different substances are widely performed. No standardization exists. This prospective study describes the results of the short-term follow-up of 56 patients with mean age 48 years (range: 30–68 years) treated with the Instant Tennis Elbow Cure Medical device, which fenestrates the injured tendon in a standardized way through a holder of 12 small needles. Depth and position of the needles are determined beforehand by ultrasonography. Unprepared autologous blood was injected through the holder in the tendon. Visual analog pain scale (VAS) decreased significantly in rest by 61% and during activity by 47% after 6 weeks. VAS decreased significantly in rest by 79% and during activity by 66% after 3 months. VAS did not remain significantly different after 6 months. Satisfaction rates were 71% after 6 weeks and 82% after 6 months. This suggests that the therapeutical effect sustains and in some cases increases over time. Patient Related Tennis Elbow Evaluation score ameliorated after 3 months by 71%. Comparative studies are needed to confirm this effect versus other techniques as physiotherapy, shockwave therapy, and injections with other substances.

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