1,721,066 research outputs found
Comparison of the Effect of Balloon Catheter vs Nucleoplasty vs Balloon Catheter and Nucleoplasty in Patients With Lumbar Spinal Stenosis
No full textBACKGROUND: Nucleoplasty and neuroplasty are often performed in patients with refractory lower back pain when conservative treatment is ineffective. Lumbar spinal stenosis (LSS) is caused by multiple factors; in some cases, a single procedure of nucleoplasty or neuroplasty alone does not provide sufficient treatment effect. OBJECTIVES: This study aimed to investigate and compare the pain relief and pain-free interval among patients with LSS who underwent nucleoplasty, neuroplasty, and combined balloon neuroplasty and nucleoplasty. STUDY DESIGN: Retrospective study. SETTING: In-ha University hospital pain clinic. METHODS: This is a retrospective study of the medical records and survey of 98 patients with LSS who visited a pain clinic between 2019 and 2020 and underwent nucleoplasty, neuroplasty, and combined balloon neuroplasty and nucleoplasty. Patients with disc height < 50% of the adjacent disc on magnetic resonance imaging and those with moderate and severe extraforaminal stenosis were excluded. Thus, 60 patients who underwent nucleoplasty (n = 20), neuroplasty (n = 20), and combined balloon neuroplasty and nucleoplasty (n = 20) for LSS were analyzed. The patients were instructed to rate their pain intensity via an 11-point numeric rating score (NRS) before and after the procedure. The Korean version of the Oswestry Disability Index (ODI) questionnaire was checked before and after the procedure. RESULTS: The pain intensity decreased to NRS 3 +/- 0.14 and 1.85 +/- 0.19 in the nucleoplasty and combined balloon neuroplasty and nucleoplasty groups, respectively, indicating a significant difference (P = 0.003). ODI was significantly decreased after the procedure compared with that before the procedure in all groups. After the procedure, ODI decreased to 13.89 +/- 0.20 and 11.21 +/- 0.33 in the nucleoplasty and combined balloon neuroplasty and nucleoplasty groups, respectively, with a significant difference between the 2 groups (P < 0.05). The patients in the nucleoplasty group achieved pain relief for 4.93 +/- 1.22 months after the procedure, whereas those in the balloon neuroplasty group achieved pain relief for 5 +/- 1.37 months. In the combined balloon neuroplasty and nucleoplasty group, pain relief was maintained for 10.2 +/- 1.11 months (P = 0.003). LIMITATIONS: The pain was assessed with NRS without considering the patients' pain medication. There may be differences in the outcome of the procedure depending on the surgeon. CONCLUSION: The pain reduction effect was greater and was retained for a longer period with combined balloon neuroplasty and nucleoplasty than with nucleoplasty or neuroplasty alone
Safety and effectiveness of pregabalin controlled-release in Korean patients with peripheral neuropathic pain: A post-marketing surveillance data
No full textChronic pain, including neuropathic pain (NP), significantly affects quality of life in 7% to 10% of the general population. The prevalence of NP is rising owing to factors such as aging, obesity, and enhanced cancer survival rates. Effective management of NP is essential to improve patient outcomes. This study aimed to assess the safety and effectiveness of controlled-release (CR) pregabalin in Korean patients with peripheral NP . An open-label, non-comparative, multicenter study was conducted with 623 participants across 18 institutions. The patients received pregabalin CR as part of their routine treatment. Safety and efficacy data were collected over 12 weeks. Pain severity was assessed using the 11-point numeric rating scale (0 = no pain, 10 = worst imaginable pain), and sleep interference was assessed using an 11-point Likert scale (0 = did not interfere, 10 = unable to sleep). Safety was evaluated through adverse event (AE) reporting. Among the 617 participants evaluated for safety, 6.32% reported AEs, primarily dizziness and somnolence. Serious AEs were rare (0.32%). The efficacy analysis included 363 participants, with significant reductions in daily pain (from 5.05 +/- 2.41 to 3.16 +/- 2.26, P < .0001) and sleep interference scores (from 2.32 +/- 2.70 to 1.42 +/- 2.18, P < .0001) at week 12. Both the patients' and clinicians' global impressions demonstrated meaningful improvements in over 26% of the participants. The efficacy was reduced in patients with a medical history and in those receiving high doses (>165 mg/d). Pregabalin CR effectively reduced NP and sleep interference, with a manageable safety profile. These findings support the use of this drug as first-line treatment for NP. Personalized treatment and continuous monitoring are recommended to optimize patient outcomes
Response After Repeated Ketamine Injections in a Rat Model of Neuropathic Pain
Get PDFKetamine, an N-methyl-D-aspartate antagonist, reduces pain by decreasing central sensitization and pain windup. However, chronic ketamine use can cause tolerance, dependency, impaired consciousness, urinary symptoms, and abdominal pain. This study aimed to investigate the effects of repeated ketamine injections and ketamine readministration after discontinuation in a rat model of neuropathic pain. To induce neuropathic pain, partial sciatic nerve ligation (PSNL) was performed in 15 male Wistar rats, and these animals were divided into three groups: PSNL (control), PSNL + ketamine 5 mg/kg (K5), and PSNL + ketamine 10 mg/kg (K10; n=5 each). Ketamine was injected intraperitoneally daily for 4 weeks, discontinued for 2 weeks, and then readministered for 1 week. Following PSNL, the mechanical withdrawal threshold was determined weekly using the Von Frey. The K10 group showed a significant increase in the mechanical withdrawal threshold, presented here as the target force (in g), at 21 and 28 days compared to the time point before ketamine injection (mean+/-SE, 276.0+/-24.0 vs. 21.6+/-2.7 and 300.0+/-0.0 vs. 21.6+/-2.7, respectively; P<0.01) and at 14, 21, and 28 days compared to the control group (108.2+/-51.2 vs. 2.7+/-1.3, 276.0+/-24.0 vs. 2.5+/-1.5, and 300.0+/-0.0 vs. 4.0+/-0.0, respectively; P<0.05). However, in the K10 group, the ketamine effects decreased significantly at 7 days after readministration compared to those after 28 days of repeated injections (P<0.05). In the K10 group, repeated ketamine injections showed a significant increase in antinociceptive effect for >2 weeks, but this ketamine effect decreased after drug readministration
Classification of nocturia by analyzing frequency volume chart and relations with international prostate symptom score in male patients with lower urinary tract symptoms in Korea
Get PDFPURPOSE: To evaluate the categories of nocturia and relationships with the international prostate symptom score (IPSS) in Korean men with lower urinary tract symptoms (LUTS) accompanying nocturia.
MATERIALS AND METHODS: Five hundred twenty-one male patients from five different hospitals, aged >/=18 years, were included. The 3-day frequency volume chart was used to identify nocturia. We also used the IPSS and The International Consultation on Incontinence Modular Questionnaire-Nocturia (ICIQ-N) module to verify the correlation between nocturia and quality of life.
RESULTS: The distribution of nocturia events varied from 1 to 11, and 2 nocturia events were most prevalent (48.4%). Across the various numbers of nocturia events, the mean age, first sleep period, functional bladder capacity (FBC), nocturnal polyuria index (NPI), nocturia index (NI), predicted number of nightly voids, and nocturnal bladder capacity index (NBCI) were statistically different. Patients with pure nocturnal polyuria showed different night lengths, nocturnal urine volume, FBC, NPI, NI, and predicted number of nightly voids than those without nocturnal polyuria. Patients with severely reduced NBCI were prominent in the IPSS >20 group, and the degree of vexation increased with the number of nocturia events. The IPSS storage symptom score and ICIQ-N symptom score positively correlated with nocturia events.
CONCLUSIONS: In Korean male LUTS patients with nocturia, mixed-type nocturia was prominent, and patients with a high IPSS had a much poorer sleep quality than those with a low IPSS
Survey on disease insight and prevalence of urinary incontinence in women
Get PDFPurpose: With a rapidly aging population in Korea, the number of patients with lower urinary tract symptoms is increasing. Therefore, it is important to determine the current extent of incontinence among Korean women to establish future plans. We attempted to create reference materials for organizing public relations and educational activities by investigating the effect of age on incontinence and quality of life in women. Materials and Methods: The participants comprised women aged 30 years and older who visited a tertiary center for health screening from September 1 to October 31, 2016. The survey included a questionnaire consisting of 12 questions that took approximately 10 minutes to complete. We analyzed the responses and assessed the prevalence of the disease and its rate of recognition. Results: A total of 509 women completed the survey. Irrespective of age, 76.8% of all respondents were aware of urinary incontinence (UI) and 57.4% of the women exhibited lower urinary tract symptoms. The most prevalent symptom was UI (45.8%), and the incidence rates of stress and urge UI were identified as 33.6% and 12.2%, respectively. Only 8.0% of the women had visited a hospital; 38.3% had awaited spontaneous symptom improvement. Many participants (61.2%) answered that a urology clinic is suitable for treating UI, while 58.9% chose a gynecology clinic. Conclusions: Our study showed that more than 75% of women are aware of UI, but their perception of the disease mechanism and treatment options was low. We suggest that continuous education and publicity are necessary
Creation of a three-dimensional printed spine model for training in pain procedures
Get PDFObjective Technological developments have made it possible to create simulation models to educate clinicians on surgical techniques and patient preparation. In this study, we created an inexpensive lumbar spine phantom using patient data and analyzed its usefulness in clinical education. Methods This randomized comparative study used computed tomography and magnetic resonance imaging data from a single patient to print a three-dimensional (3D) bone framework and create a mold. The printed bones and structures made from the mold were placed in a simulation model that was used to train residents. The residents were divided into two groups: Group L, which received only an audiovisual lecture, and Group P, which received an additional 1 hour of training using the 3D phantom. The performance of both groups was evaluated using pretest and post-test analyses. Results Both the checklist and global rating scores increased after training in both groups. However, some variables improved significantly only in Group P. The overall satisfaction score was also higher in Group P than in Group L. Conclusions We have described a method by which medical doctors can create a spine simulation phantom and have demonstrated its efficiency for procedural education
A Multicenter, Open-Label, Observational Study Evaluating the Quality of Life After Using a Hydrophilic-Coated Catheter (SpeediCath) With Self-Intermittent Catheterization
Get PDFPURPOSE: We evaluated the change in patient quality of life after the use of a hydrophilic-coated catheter (SpeediCath) in adults requiring intermittent catheterization (IC). METHODS: This was a multicenter, open-label, observational study using the Patient Perception of Intermittent Catheterization (PPIC) questionnaire and the Intermittent Self-Catheterization questionnaire (ISC-Q) and safety at 12 and 24 weeks in adult patients who had already used other type of catheters prior to switching to SpeediCath or in patients undergoing self-IC for the first time for any reason. RESULTS: Among a total of 360 subjects, 215 (59.7%) were women, and the mean age was 62.0+/-13.2 years. At 24 weeks, the satisfaction rate after using SpeediCath was 84.1%, and 80% of patients responded that they could easily perform IC. In total, 81.6% of patients were willing to continue using SpeediCath. The mean ISC-Q score was 54.90+/-18.65 at 24 weeks. Men found less interference in their daily life by performing IC than women and found it easier to handle the catheter before it was inserted into the urethra. At week 12, the mean change in ISC-Q was significantly greater in patients <65 years (20.24+/-23.55) than in those >/=65 years (7.57+/-27.70, P=0.049), but there was no difference at 24 weeks. The most common adverse events were urinary tract infection in 9.72%, gross hematuria in 2.78%, and urethral pain in 1.39%. CONCLUSION: The use of a SpeediCath provided good quality of life for patients who needed self-IC regardless of age or sex
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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