Publications by authors named "Ryan D'Souza"

Pain serves as a vital innate defense mechanism that can significantly impact an individual's quality of life. Understanding the physiological effects of pain well plays an important role in developing novel pain treatments. Nociceptor neurons play a key role in pain and inflammation.

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Background: As cannabis legalization expands nationally and globally, its use for chronic pain increases, prompting people to seek information on social media platforms like YouTube. This study evaluates the accuracy and quality of information of popular YouTube videos on cannabis for chronic pain.

Methods: Using search terms related to cannabis for pain, the top 66 videos by view count were selected.

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This article describes minimally invasive treatments for managing chronic low back pain (LBP) related to lumbar spinal stenosis, facetogenic LBP, vertebrogenic LBP, or discogenic LBP. We also propose a clinical decision-making tool to guide clinicians in appropriate patient selection for various treatments.

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Article Synopsis
  • - Menopause occurs between ages 45 and 55, marking the end of a woman's reproductive years, and often involves overlooked pain such as musculoskeletal discomfort, headaches, and vulvovaginal pain.
  • - The causes of menopausal pain are complex, tied to hormonal changes, psychosocial factors, and genetics, which can worsen perception of pain due to issues like mood disorders and lack of sleep.
  • - The article calls for more research to better understand menopausal pain and emphasizes the importance of effective management strategies to improve the wellbeing and quality of life for women during this transition.
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  • The text discusses a rare type of orofacial pain related to sympathetic nervous system issues, which often doesn't respond well to standard treatments.
  • It presents two specific cases where cervical spinal cord stimulation (SCS) using a burst waveform technique was employed, showing promising results in pain relief.
  • The findings suggest that while cervical SCS could be a beneficial option for managing this type of pain, more comprehensive randomized studies are needed to solidify its effectiveness and long-term outcomes.
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  • Clinical interest in peripheral nerve stimulation (PNS) has grown due to its potential benefits for chronic pain management over traditional medications, but variability in its use persists due to the lack of clear guidelines and standardized systems.
  • A survey of 94 pain physicians revealed that PNS is most commonly used for neuropathic pain conditions, such as peripheral neuralgia, while its application for nociceptive pain like chronic low back pain and osteoarthritis shows mixed results.
  • The study highlights the common practice of conducting nerve blocks prior to PNS for anatomical verification, with practitioners seeking a minimum 50% to 75% pain relief as a requirement to proceed with treatment.
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  • * A study analyzed 714 patients, finding that 34% of chronic pain and 25% of substance use disorder patients received formal preoperative evaluations before elective surgeries.
  • * Those evaluated were more likely to receive non-opioid pain management methods, indicating that preoperative assessments can improve surgical outcomes for these patients.
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Background: Randomized clinical trials (RCTs) are considered the gold standard for evaluating the efficacy of healthcare interventions. However, conflicts of interest (COIs) can compromise the scientific integrity in these trials. This study characterized COIs in RCTs on spinal cord stimulation for chronic pain, focusing on the prevalence, disclosure, and monetary value of COIs.

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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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Purpose: Injectable biologics have not only been described and developed to treat dermal wounds, cardiovascular disease, and cancer, but have also been reported to treat chronic pain conditions. Despite emerging evidence supporting regenerative medicine therapy for pain, many aspects remain controversial.

Methods: The American Society of Pain and Neuroscience (ASPN) identified the educational need for an evidence-based guideline on regenerative medicine therapy for chronic pain.

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Nationally representative rates of incident prescription opioid use in the United States adult population and selected subpopulations are unknown. Using the National Health Interview Survey (2019-2020) longitudinal cohort, a cohort with 1-year follow-up created using random cluster probability sampling of noninstitutionalized civilian U.S.

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This series of FactFinders presents a brief summary of the evidence and outlines recommendations to improve our understanding and management of potential procedure-related complications. Evidence in support of the following facts is presented. (1) -- There is low-level evidence of an association between epidural steroid injections (ESIs) and the development and/or worsening of spinal epidural lipomatosis (SEL).

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Chronic pain is increasing in prevalence, with new cases now outnumbering those of diabetes, depression, or hypertension. Advanced practice providers have reported that their training in pain management inadequately prepared them to care for patients suffering from painful conditions. In response, the authors of this work developed a basic pain management conceptual framework to provide physician assistant (PA) students with the foundational knowledge necessary to manage and treat patients suffering from a wide variety of painful conditions.

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Neuromodulation is being utilized across a variety of medical subspecialties to treat both painful and non-painful medical conditions. However, publications on neuromodulation topics infrequently occur in journals targeting generalists and medical specialties outside of pain medicine and neurosurgery. This study reviewed implantable neuromodulation devices, their respective Food and Drug Administration-approved indications for use, as well as off-label usage, and the associated potential risks and benefits for each device.

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Article Synopsis
  • Chemotherapy-induced peripheral neuropathy (CIPN) can occur after cancer treatment, and spinal cord stimulation (SCS) is being explored for treating severe cases.
  • A study examined the effectiveness of two types of SCS (tonic vs. burst) in improving pain and gait in patients with CIPN, alongside quantitative sensory testing (QST) outcomes.
  • Results showed improvements in gait scores and pain relief, although some sensory testing outcomes were inconsistent; the study highlights the potential of different SCS waveforms in managing CIPN and emphasizes the importance of psychophysical testing as a monitoring tool.
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Objective: Peripheral nerve stimulation (PNS) is an emerging neuromodulation modality, yet there remains limited data highlighting its long-term effectiveness. The objective of this study was to report real-world data on pain intensity and opioid consumption after temporary and permanent PNS for chronic pain up to 24 months postimplantation.

Methods: A retrospective study was conducted on all patients who received PNS implants at a multi-centered enterprise between January 1, 2014 and February 24, 2022.

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PURPOSE OF REVIEW: The purpose of this narrative review is to evaluate the efficacy of the most commonly studied intradiscal biologics used for the treatment and alleviation of chronic intractable discogenic low back pain. Additionally, it explores the therapeutic potential and durability of these novel treatment options. RECENT FINDINGS: Recently published literature highlights the therapeutic potential of intradiscal biologics, such as mesenchymal stem cells, platelet-rich plasma, and alpha-2-macroglobulin, in promoting chondrogenesis within the lumbar intervertebral discs to treat discogenic low back pain.

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Background: Gabapentin, a widely prescribed medication for various neuropathic pain conditions, has demonstrated efficacy in managing diverse neurological disorders. While conventional side effects are well-documented, a growing body of evidence suggests the existence of atypical side effects, necessitating comprehensive exploration. This paper aims to systematically review and summarize the literature on the atypical side effects of gabapentin, shedding light on manifestations beyond the conventional spectrum.

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