Therapeutic Actions Prevent Pain

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Angiographic Anatomy and Relevance of 3 and 9 O'clock Arteries During Radioembolization.

Related Articles Angiographic Anatomy and Relevance of 3 and 9 O'clock Arteries During Radioembolization. Cardiovasc Intervent Radiol. 2018 Jan 17;: Authors: Powerski M, Bascik B, Omari J, El-Sanosy S, Grosser OS, Seidensticker M, Fischbach F, Pech M Abstract PURPOSE: 3 and 9 o'clock arteries (3&9As) which supply the common hepatic duct connect hepatic with duodenal/pancreatic territories. The study purpose is to describe the angiographic anatomy of 3&9As and discuss their relevance when performing radioembolization (RE) of liver malignancies. MATERIALS AND METHODS: The anatomy of the 3&9As was systematically investigated by a retrospective analysis of angiograms, technetium Tc-99 m-macroaggregated albumin (MAA) scintigrams, yttrium-90 (Y90) Bremsstrahlung-SPECT/CT datasets, and clinical data of 153 patients who underwent RE between 2010 and 2013. RESULTS: Analysis of preprocedural angiograms identified 3&9As in 36 (24%) of the 153 patients. Following embolization of the gastroduodenal artery, 3&9As were seen in 53 cases (35%). The three most common origins of the 3&9As were the right hepatic artery (n = 14), the cystic artery (n = 11), and S5 and S6 segmental arteries (n = 5 each). Extrahepatic Tc-99 m-MAA deposition in the territory of the 3&9As was significantly more frequent when 3&9As were detectable on preprocedural angiograms (28%visible vs. 11%not visible; p = 0.001) and especially when the 3&9As were not embolized or bridged prior to RE (50%not occluded/bridged vs. 19%occupied/bridged; p = 0.043). The presence of extrahepatic Y90 Bremsstrahlung after RE (n = 17) was attributable to microsphere diversion via the 3&9A territory in four patients and possible diversion via this territory in nine patients. Five of these 13 patients presented with epigastric pain, nausea, or vomiting (CTCAE severity grade ≤ 3) (p = 0.014). CONCLUSION: 3&9As are commonly detectable during evaluation angiography prior to RE, have a variable angioanatomic origin, and should be prophylactically occluded to prevent complications. PMID: 29344714 [PubMed - as supplied by publisher]

Standing Height as a Prevention Measure for Overuse Injuries of the Back in Alpine Ski Racing: A Kinematic and Kinetic Study of Giant Slalom.

Related Articles Standing Height as a Prevention Measure for Overuse Injuries of the Back in Alpine Ski Racing: A Kinematic and Kinetic Study of Giant Slalom. Orthop J Sports Med. 2018 Jan;6(1):2325967117747843 Authors: Spörri J, Kröll J, Fasel B, Aminian K, Müller E Abstract Background: In alpine ski racing, typical loading patterns of the back include a combined occurrence of spinal bending, torsion, and high peak loads. These factors are known to be associated with high spinal disc loading and have been suggested to be attributable to different types of spine deterioration. However, little is known about the effect of standing height (ie, the distance between the bottom of the running surface of the ski and the ski boot sole) on the aforementioned back loading patterns. Purpose: To investigate the effect of reduced standing height on the skier's overall trunk kinematics and the acting ground-reaction forces in giant slalom (GS) from an overuse injury prevention perspective. Study Design: Controlled laboratory study. Methods: Seven European Cup-level athletes skied a total of 224 GS turns with 2 different pairs of skis varying in standing height. Their overall trunk movement (frontal bending, lateral bending, and torsion angles) was measured based on 2 inertial measurement units located at the sacrum and sternum. Pressure insoles were used to determine the total ground-reaction force. Results: During the turn phase in which the greatest spinal disc loading is expected to occur, significantly lower total ground-reaction forces were observed for skis with a decreased standing height. Simultaneously, the skier's overall trunk movement (ie, frontal bending, lateral bending, and torsion angles) remained unwaveringly high. Conclusion: Standing height is a reasonable measure to reduce the skier's overall back loading in GS. Yet, when compared with the effects achievable by increased gate offsets in slalom, for instance, the preventative benefits of decreased standing height seem to be rather small. Clinical Relevance: To reduce the magnitude of overall back loading in GS and to prevent overuse injuries of the back, decreasing standing height might be an efficient approach. Nevertheless, the clinical relevance of the current findings, as well as the effectiveness of the measure "reduced standing height," must be verified by epidemiological studies before its preventative potential can be judged as conclusive. PMID: 29344540 [PubMed]

Essential oil-loaded lipid nanoparticles for wound healing.

Related Articles Essential oil-loaded lipid nanoparticles for wound healing. Int J Nanomedicine. 2018;13:175-186 Authors: Saporito F, Sandri G, Bonferoni MC, Rossi S, Boselli C, Icaro Cornaglia A, Mannucci B, Grisoli P, Vigani B, Ferrari F Abstract Chronic wounds and severe burns are diseases responsible for severe morbidity and even death. Wound repair is a crucial process and tissue regeneration enhancement and infection prevention are key factors to minimize pain, discomfort, and scar formation. The aim of this work was the development of lipid nanoparticles (solid lipid nanoparticles and nanostructured lipid carriers [NLC]), to be loaded with eucalyptus or rosemary essential oils and to be used, as medical devices, to enhance healing of skin wounds. Lipid nanoparticles were based on natural lipids: cocoa butter, as solid lipid, and olive oil or sesame oil, as liquid lipids. Lecithin was chosen as surfactant to stabilize nanoparticles and to prevent their aggregation. The systems were prepared by high shear homogenization followed by ultrasound application. Nanoparticles were characterized for physical-chemical properties, bioadhesion, cytocompatibility, in vitro proliferation enhancement, and wound healing properties toward normal human dermal fibroblasts. Antimicrobial activity of nanoparticles was evaluated against two reference microbial strains, one of Staphylococcus aureus, the other of Streptococcus pyogenes. Finally, the capability of nanoparticles to promote wound healing in vivo was evaluated on a rat burn model. NLC based on olive oil and loaded with eucalyptus oil showed appropriate physical-chemical properties, good bioadhesion, cytocompatibility, in vitro proliferation enhancement, and wound healing properties toward fibroblasts, associated to antimicrobial properties. Moreover, the in vivo results evidenced the capability of these NLC to enhance the healing process. Olive oil, which is characterized by a high content of oleic acid, proved to exert a synergic effect with eucalyptus oil with respect to antimicrobial activity and wound repair promotion. PMID: 29343956 [PubMed - in process]

Pregabalin versus placebo in targeting pro-nociceptive mechanisms to prevent chronic pain after whiplash injury in at-risk individuals - a feasibility study for a randomised controlled trial.

Related Articles Pregabalin versus placebo in targeting pro-nociceptive mechanisms to prevent chronic pain after whiplash injury in at-risk individuals - a feasibility study for a randomised controlled trial. Trials. 2018 Jan 17;19(1):44 Authors: Nikles J, Keijzers G, Mitchell G, Schug S, Ware R, McLean SA, Connelly L, Gibson S, Farrell SF, Sterling M Abstract BACKGROUND: Whiplash-associated disorders (WAD) are an enormous and costly burden to Australian society. Up to 50% of people who experience a whiplash injury will never fully recover. Whiplash is resistant to treatment and no early management approach has yet been shown to prevent chronic pain. The early presence of central sensitization is associated with poor recovery. Pregabalin's effects on central sensitization indicate the potential to prevent or modulate these processes after whiplash injury and to improve health outcomes, but this has not been investigated. This paper describes the protocol for a feasibility study for a randomised controlled trial of pregabalin plus evidence-based advice compared to placebo plus evidence-based advice for individuals with acute whiplash injury who are at risk of poor recovery. METHODS: This double blind, placebo-controlled randomised feasibility study will examine the feasibility and potential effectiveness of pregabalin and evidence-based advice (intervention) compared to placebo and evidence-based advice (control) for individuals with acute whiplash injury at risk of poor recovery. Thirty participants (15 per group) aged 18-65 years with Grade II WAD, within 48 hours of injury and currently experiencing at least moderate pain (NRS: ≥ 5/10) will be recruited from Emergency Departments of public hospitals in Queensland, Australia. Pregabalin will be commenced at 75 mg bd and titrated up to 300 mg bd as tolerated for 4 weeks followed by 1 week of weaning. RESULTS: The feasibility of trial procedures will be tested, as well as the potential effect of the intervention on the outcomes. The primary outcome of neck pain intensity at 3 months from randomisation will be compared between the treatment groups using standard analysis of variance techniques. DISCUSSION: Feasibility and potential effectiveness data will inform an appropriately powered full trial, which if successful, will provide an effective and cost-effective intervention for a costly and treatment resistant condition. It will also have implications for the early management of other traumatic conditions beyond whiplash. TRIAL REGISTRATION: Clinical Trials Primary Registry: Australian and New Zealand Clinical Trials Registry. CLINICAL TRIAL REGISTRATION NUMBER: ACTRN12617000059369 . Date of Registration: 11/01/2017. Primary Trial Sponsor: The University of Queensland, Brisbane QLD 4072 Australia. PMID: 29343280 [PubMed - in process]