Publications by authors named "Thomas Pittelkow"

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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Article Synopsis
  • Acupuncture is widely sought for chronic pain treatment, and this study analyzes the quality and accuracy of related content found on YouTube.
  • Researchers assessed 54 popular videos, categorizing them as useful, misleading, or neutral while using established quality assessment tools.
  • Results showed that over half of the videos were useful, with those produced by healthcare institutions scoring higher on quality metrics compared to misleading content primarily made by health media.
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Postdural puncture headache is a frequently encountered complication following procedures such as lumbar puncture, neuraxial anesthesia, or intrathecal drug delivery device implantation. It classically presents as a painful orthostatic headache that is exacerbated when a patient is upright. For treatment, patients are often started on conservative options such as hydration, caffeine, bedrest, and NSAID analgesics; however, certain patients who fail these therapies may require intervention with an epidural blood patch.

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Background: Complex regional pain syndrome is a chronic pain condition characterized by autonomic dysfunction, changes in sympathetic and vasomotor activity, and sensory and motor changes. Complex regional pain syndrome is a clinical diagnosis and may occur after trauma or surgery. Complex regional pain syndrome-related pain may occur spontaneously and is out of proportion with the inciting event.

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  • Shoulder arthroplasty is a surgery that helps people with serious shoulder problems, but some people still have pain afterward.
  • If someone has ongoing pain, they should see a shoulder doctor to find out why and if more surgery is needed.
  • The article talks about reasons for this pain, how to check it, and different ways to help manage the pain better in the future.
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Objectives: The purpose of this single center, prospective randomized controlled trial was to compare clinical outcomes between an ultrasound-guided greater occipital nerve block (GONB) at the C2 vertebral level versus landmark-based GONB at the superior nuchal line.

Methods: Patients with occipital neuralgia or cervicogenic headache were randomized to receive either a landmark-based GONB with sham ultrasound at the superior nuchal line or ultrasound-guided GONB at the C2 vertebral level with blinding of patients and data analysis investigators. Clinical outcomes were assessed at 30 minutes, 2 weeks, and 4 weeks postinjection.

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  • The field of neurostimulation for chronic pain is advancing quickly, emphasizing the importance of not just technological improvements but also surgical planning and postoperative care for optimal patient outcomes.
  • Experts conducted a thorough literature review from multiple databases to provide evidence-based recommendations for preoperative assessment, surgical techniques, and postoperative management, using rigorous grading criteria for studies.
  • The NACC's guidance aims to enhance the overall efficiency and safety of neuromodulation procedures, addressing the entire patient journey from planning to recovery, and is intended for use in the global medical community.
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Spinal cord and dorsal root ganglion stimulation are minimally invasive surgical techniques used to treat an array of chronic pain disorders. There is a paucity of data related to defining best practices in these specific patient populations, and historically, providers have relied on consensus committees to opine on the best techniques for patient safety and experience. The most efficacious mechanism of surgical closure-specifically a running suture closure compared to a surgical staple closure-is debated.

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The primary aim of this randomized clinical trial is to investigate the effects of ultrasound-guided transversus abdominis plane (TAP) vs ultrasound-guided trigger point injections (TPIs) on numerical rating scale pain scores at month 3 follow-up in patients with a chronic abdominal wall pain. The primary outcome measure was the difference in mean numeric rating scale pain scores between the TAP and TPI groups at month 3 in an intent-to-treat (ITT) analysis. A total of 60 patients were randomized 1:1 to receive an ultrasound-guided TAP block (n = 30) or an ultrasound-guided TPI (n = 30).

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Cancer and cancer treatment-related chronic pain affect a significant number of patients. The etiology of this pain is diverse and may include nociceptive and/or neuropathic characteristics. Treatment is often multifactorial and may require advanced interventional techniques, such as spinal cord stimulation (SCS).

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  • Spinal cord stimulation (SCS) is a recognized therapy for treating chronic pain, yet pain medicine fellows come with different levels of experience and skills; this study aims to evaluate their surgical performance using a new assessment tool based on the Zwisch scale.* -
  • Conducted at Mayo Clinic, the study involved 10 faculty members and 5 fellows, utilizing a set rubric to assess various surgical skills, including technique and access, and gathering feedback through surveys before and after using the assessment tool.* -
  • Results showed that both faculty and fellows experienced increased satisfaction and communication regarding skill assessments, indicating that the tool improved the consistency and efficiency of feedback in training for SCS procedures.*
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Background/objective: Chronic pain is commonly reported in individuals with spinal cord injuries (SCIs), with recent prevalence reported as high as 80%. Uncontrolled pain is known to decrease quality of life, attenuate mood, and impact sleep. Spinal cord stimulation (SCS) for the treatment of refractory pain was first used in the SCI population in 1972.

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Background: Women are entering medical school in record numbers, but multiple male-dominated medical specialties still exist, including pain medicine. It is not well-understood how gender diversity in academic pain medicine faculty affects fellow matriculation between female and male applicants.

Objective: We conducted a survey to ascertain whether gender diversity of those in leadership roles in pain medicine programs impacts the gender diversity of fellows in those programs.

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Introduction: Some patients with head and neck cancers have pain refractory to aggressive multimodal therapies. Herein, we report the use of an intrathecal targeted drug delivery (TDD) system catheter tip placed at C1 for the treatment of recalcitrant oropharyngeal cancer pain.

Case Report: A patient with recurrent metastatic squamous cell tongue cancer reported severe pain not controlled despite high-dose opioids and nonopioid adjuvants.

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Article Synopsis
  • Pain is a big worry for people with cancer and their families, and many don't get enough help to manage it.
  • Using opioids (strong pain medications) can cause serious problems for the brain and overall health.
  • It's important for healthcare teams to work together and get patients the right pain specialists early on, so they can get better care and less suffering.
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Pain is one of the most commonly experienced and feared symptoms faced by patients with a serious illness. For these patients, intrathecal drug delivery systems (IDDSs) provide greater potency and/or few systemic side effects. However, despite these benefits, the integration and management of IDDS for patients receiving hospice care has not been previous studied.

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Objectives: Exploratory research quantifying the change of spasticity among patients who underwent baclofen intrathecal drug delivery system (IDDS) implantation.

Patients And Methods: 88 patients with a baclofen IDDS were identified. Patient characteristics, spasticity scores pre/post intrathecal baclofen test dose, and IDDS perioperative implantation records were collected.

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  • The study looked at how using ultrasound could help doctors in training improve their skills in feeling a specific tendon in the shoulder.
  • It aimed to see if the accuracy in finding this tendon got better after a short training session with ultrasound.
  • The results showed that after the training, the trainees were more accurate in finding the tendon compared to before the training.
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Objective: The goal of this study was to determine the frequency and clinical indications associated with implantation of single vs. dual percutaneous lead spinal cord stimulator (SCS) systems and to look further into how these leads are utilized for treatment.

Materials And Methods: A retrospective cohort analysis of all patients undergoing SCS implantation between January 2001 and December 2013 with a minimum of 2 years of clinical follow-up was performed.

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Introduction: Surgical site infection is a potential complication of spinal cord stimulator (SCS) implantation. Current understanding of the epidemiology, diagnosis, and treatment of these infections is based largely on small clinical studies, many of which are outdated. Evidence-based guidelines for management of SCS-related infections thus rely instead on expert opinion, case reports, and case series.

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Background: Occipital neuromodulation is a promising treatment modality for refractory headache, but lead migration remains a frequent surgical complication.

Objectives: The primary objective was to identify surgical techniques that may minimize adverse events, particularly lead migration. We hypothesized that a surgical technique employing 2-point anchoring of stimulator leads designed to provide a tension-relief loop and the use of ultrasound for lead placement would decrease the complication rate.

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Objective: To distinguish which patients with bone metastases are at risk for near-term disablement in order to assist clinicians in assessing the appropriateness of referrals for rehabilitation services.

Design: Prospective cohort study.

Setting: National Cancer Institute-designated comprehensive cancer center imbedded in a tertiary medical center.

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