Publications by authors named "Ivan Urits"

Article Synopsis
  • - Spinal cord stimulation (SCS) is a minimally invasive method used to treat severe neuropathic pain, but it's important to be aware of possible biologic complications during implantation.
  • - Although biologic complications like infection and nerve injury happen less often than device-related issues, they can have more serious effects on patients.
  • - Understanding these potential complications is essential for doctors to ensure patient safety and improve outcomes when using SCS for pain management.
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Objective: To retrospectively assess the Thoracolumbar Injury Classification and Severity Score (TLICS) in patients with osteoporotic vertebral compression fractures (OVCF) and compare the treatment given with that predicted by the TLICS score.

Methods: All medical records of patients presenting from January 2014 to November 2017 for acute atraumatic or low impact OVCF were screened, and eligible patients were retrospectively reviewed. The TLICS score was determined based upon magnetic resonance imaging (MRI) findings and clinical records.

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Post-traumatic stress disorder (PTSD) stands as a pervasive psychiatric condition, exerting a profound impact on millions across the globe. Despite the availability of traditional therapeutic modalities, many individuals continue to grapple with suboptimal treatment outcomes, underscoring the urgent need for novel interventions. In recent years, stellate ganglion blocks (SGBs) have garnered attention as a promising avenue in the treatment landscape for PTSD, showcasing remarkable efficacy in ameliorating symptomatology and enhancing overall quality of life.

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Purpose Of Review: This is a comprehensive review of the literature regarding Lemborexant for the treatment of insomnia. It covers the background and management of insomnia and then reviews the body of existing evidence evaluating the use of Lemborexant for this purpose.

Recent Findings: Insomnia leads to significant decreased in quality of life and economic burden due to decreased workplace performance and increased health care costs.

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Purpose Of Review: This is a comprehensive review of the literature regarding the use of Solriamfetol for excessive daytime sleepiness. It covers the background and current therapeutic approaches to treating excessive daytime sleepiness, the management of common comorbidities, and the existing evidence investigating the use of Solriamfetol for this purpose.

Recent Findings: Excessive daytime sleepiness leads to worse quality of life, a medical sequela and significant economic cost.

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Bertolotti's syndrome, also known as lumbosacral transitional vertebrae, is a relatively rare spinal condition characterized by an anatomical variation in the lower spine. Conservative approaches such as physical therapy, anti-inflammatory medications and lifestyle modifications may be recommended for mild cases. In more severe cases or when conservative measures fail to provide relief, injections such as may be considered to alleviate pain.

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Purpose Of Review: The surge in orthopedic surgeries strains the US healthcare system, necessitating innovative rehabilitation solutions. This review examines the potential of virtual reality (VR)-based interventions for orthopedic rehabilitation.

Recent Findings: The effectiveness of VR-based interventions in orthopedic surgery patients is scrutinized.

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There is a lack of evidence to support the effectiveness of long-term opioid therapy in patients with chronic, noncancer pain. Despite these findings, opioids continue to be the most commonly prescribed drug to treat chronic back pain and many patients undergoing spinal surgery have trialed opioids before surgery for conservative pain management. Unfortunately, preoperative opioid use has been shown repeatedly in the literature to negatively affect spinal surgery outcomes.

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Purpose Of Review: Osteoarthritis (OA) is a prevalent and debilitating condition characterized by joint degeneration and pain. Current treatment options aim to alleviate symptoms and slow disease progression but lack curative potential. Stem cell therapies have emerged as a promising alternative.

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Purpose Of Review: The aim of this review is to educate healthcare professionals regarding buprenorphine for the use of opioid use disorder (OUD) as well as for chronic pain management. This review provides physicians and practitioners with updated information regarding the distinct characteristics and intricacies of prescribing buprenorphine.

Recent Findings: Buprenorphine is approved by the US Food and Drug Administration (FDA) for acute pain, chronic pain, opioid use disorder (OUD), and opioid dependence.

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Chronic nonmalignant pain is recognized as a complex, dynamic, phenomenological interplay between biological, psychological, and social factors that are individual to the person suffering from it. Therefore, its management and treatment ought to entail the individual's biopsychosocial aspects that are often addressed by collaborative, inter/multidisciplinary multimodal care, as there is no biologic treatment. In an effort to enhance inter/multidisciplinary multimodal care, a narrative review of arts therapy as a mind-body intervention and its efficacy in chronic pain populations has been conducted.

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Heavy societal stigma of certain conditions has created an environment where individuals may be hesitant to seek professional care. Urology is a specialized field that focuses on many of these conditions that society has deemed taboo to discuss. In this review, we address barriers that have prevented patients from seeking urologic care in order to better understand and elucidate important concerns within development of the physician-patient relationship.

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Article Synopsis
  • * Treatment for DBP primarily focuses on conservative methods like behavior changes, medications, and non-drug therapies, while invasive treatments are reserved for specific cases; there's not much specific data for DBP, so chronic LBP treatment data is often referenced instead.
  • * Although there are different treatments for DBP with varying results, new methods like biologics show potential, but more research is needed to determine the best treatment strategies.
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Naltrexone is a mu-opioid receptor antagonist with a long half-life compared with naloxone. Both of these drugs, along with others, were developed with the intention of reversing the effects of opioid abuse or toxicity. Evidence has also shown that naltrexone has a benefit in preventing relapse by reducing opioid cravings and reducing symptoms of opioid withdrawal.

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Lower Urinary Tract Symptoms (LUTS) are frequently present in the general population as patients age with approximately a third of individuals experiencing LUTS during their lifetime. LUTS can be further defined as having any of the following symptoms: urinary hesitancy, straining, nocturia, increased urination frequency, and dysuria. LUTS has the potential for patients to contribute their symptoms to what can normally occur as we age.

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With the ongoing opioid epidemic in the United States there has been a strong transition towards utilizing multi-modal analgesia, interventional procedures, and non-opioid medications when managing acute and chronic pain. There has also been an increased interest in utilizing buprenorphine. Buprenorphine is a novel long-acting analgesic with partial mu-opioid agonist activity that can be utilized for analgesia as well as opioid use disorder.

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Article Synopsis
  • Headaches, particularly migraines, affect a significant portion of the population (up to 15.9%), and treatments include lifestyle modifications, medication, and minimally invasive techniques like peripheral nerve stimulation (PNS) and pericranial nerve blocks (PNB).
  • Recent studies highlight PNBs, which involve injecting local anesthetics (with or without corticosteroids), as effective for treating migraines, with the greater occipital nerve block (GONB) being the most researched and successful, helping with various types of headaches.
  • The review aims to synthesize recent findings regarding PNBs' effectiveness in managing migraines, alongside a brief overview of PNS.
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Burning mouth syndrome is a condition characterized by a painful burning sensation in the oral mucosa lasting at least 3-6 months with no definitive etiology. The pathophysiology is not well understood, though there appears to be a connection with other neuropsychiatric conditions such as depression, anxiety, and mood disorders. We briefly discuss our experience with a patient who suffered from this conidtion and how it was treated with mandibular and maxillary nerve blocks after failing more conservative pharmacological options.

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Purpose Of Review: Meralgia paresthetica (MP) is a condition characterized by paresthesias, neuropathic pain, and alterations in sensorium of the anterolateral thigh secondary to impingement of the lateral femoral cutaneous nerve (LFCN). MP is generally diagnosed by clinical history and is often a diagnosis of exclusion. When diagnosis remains a challenge, diagnostic modalities such as ultrasound, MRI, electromyography, and nerve conduction studies have been utilized as an adjunct.

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Koro syndrome is a multi-tiered disease presenting as an overwhelming belief that one's sex organs are shrinking into their body. Moderate to severe anxiety attacks are associated with the condition, along with a fear of imminent death. Koro is often culturally related and is most seen as an epidemic form in East and Southeast Asia, although it can present anywhere worldwide in its sporadic form.

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Spinal cord stimulation (SCS) is a viable treatment option for chronic pain. One of the primary indications for SCS implantation is persistent pain after spinal surgery. Studies have demonstrated that these patients have a better response to SCS over conservative management or repeat surgery.

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Article Synopsis
  • hATTR is a hereditary form of amyloidosis affecting around 50,000 people globally, commonly presenting as cardiac issues, polyneuropathy, or oculoleptomeningeal symptoms, with polyneuropathy being the most prevalent.
  • Recent advancements in treatment include Patisiran and Inotersen, which are RNA-targeted therapies that reduce the production of the transthyretin protein, aiming to mitigate the disease's progression.
  • The prognosis for hATTR is poor, typically with a median survival of less than 12 years, but these novel therapies offer promising strategies by addressing the disease at a genetic level.
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