Recent Trends in Medical Management of Endometriosis.

Endometriosis affects about 10 percent women in the reproductive age group globally and approximately 42 million in India. Managing the patient's pain symptoms associated with endometriosis appears to be the cornerstone in endometriosis disease management. The ideal medical treatment in endometriosis would be suppressing estradiol enough to alleviate symptoms of endometriosis but maintain sufficient levels to mitigate hypoestrogenic side effects.

Extended Reality Analgesia Evidence Reviews Often Lack Sufficient Intervention Detail.

Background: Evidence synthesis projects such as systematic reviews and meta-analyses are defined by the focal research question addressed through assemblage and analysis of all relevant literature. In complex intervention domains such as medical extended reality (MXR), there are a plethora of intervention factors that could be included in research questions, which define study inclusion criteria and, in turn, shape the generalizability of results. This article quantifies how recently published evidence syntheses of MXR interventions for pain management characterize the primary studies they assess.

Real-world healthcare utilization and costs of peripheral nerve stimulation with a micro-IPG system.

Aim: To characterize real-world healthcare resource utilization (HCRU) and costs in adults with chronic pain of peripheral nerve origin treated with peripheral nerve stimulation (PNS) using the micro-implantable pulse generator (IPG).

Materials & Methods: This retrospective observational study (9/1/19-1/31/23) linked patients from the Nalu medical database to the OM1 Real-World Data Cloud (RWDC). Eligible patients received the micro-IPG implant for PNS, were identifiable in both databases, and had ≥ 12 months of RWDC pre/post-implantation claims data.

The Use of Liposomal Bupivacaine for Pain Control After Shoulder Surgery: A Systematic Review and Meta-analysis.

Background: Liposomal bupivacaine (LB) is a relatively novel anesthetic agent used in the management of postoperative pain in patients who have undergone shoulder surgery.

Purpose: To explore the literature on LB in the setting of shoulder surgery and assess its efficacy and utility in managing postoperative pain.

Study Design: Systematic review and meta-analysis; Level of evidence, 1.

The Patient Perspective on Discussion of Perioperative Code Status: A Blind Spot in Efforts to Promote Goal-Concordant Surgical Care.

Despite long-standing recognition that providers should discuss DNR (do-not-resuscitate) orders prior to surgery, there is evidence that perioperative code status discussions are frequently of limited quality. Limited attention has been paid to patient perspectives. Determine the scope of literature on management of perioperative DNR orders from the patient perspective.

Exploring diagnostic stewardship in the emergency department evaluation of pediatric abdominal pain in a statewide quality collaborative.

Background: Diagnostic stewardship is the effort to optimize diagnostic testing to reduce errors while avoiding overtesting and overtreatment. Abdominal pain and appendicitis in children are essential use cases. Delayed diagnosis of appendicitis can be dangerous and even life-threatening, but overtesting is harmful.

Effect of Biomedical Hydrogels on Exercise-induced Muscle Damage: A Narrative Review.

Exercise-induced muscle damage (EIMD) is a common occurrence among athletes and individuals engaged in physical fitness activities. Muscle strains result from excessive or repetitive muscle tension, leading to tissue damage, inflammation, and pain. These strains can range from mild discomfort to severe damage, resulting in pain, inflammation, and reduced functionality.

Enoxaparin-Induced Bullous Hemorrhagic Dermatosis and Enoxaparin Rechallenge: A Case Report.

A case of enoxaparin-induced bullous hemorrhagic dermatosis is reported. A 69-year-old male with past medical history including chronic atrial fibrillation and a re-do aortic valve replacement, anticoagulated on warfarin, received an enoxaparin bridge for a molar extraction. On day 7 after restarting enoxaparin post-procedure at a therapeutic dose of 90 mg every 12 hours, the patient noticed multiple small, dark, raised lesions on his forearm and ankle.

The association between screened psychological risk for disability and appropriateness of orthopedic surgery in patients with musculoskeletal disorders - data from a Swedish RCT in primary care 2009-2011.

Introduction: To understand, diagnose and treat patients with musculoskeletal disorders, psychological risk factors should be assessed, and the association between psychological risk for disability and appropriateness of orthopedic surgery should be investigated.

Purpose: To investigate the association between screened psychological risk for disability and appropriateness of orthopedic surgery, and to examine a physiotherapist's ability to assess risk for disability in patients referred for orthopedic consultation.

Method: Patients ( = 192) were assessed by a physiotherapist or an orthopedic surgeon to determine the need for surgery.

Ultrasonography-guided aspiration and sclerotherapy for simple renal cysts in children: a comparative study with laparoscopic deroofing and optimization of therapeutic approaches.

Objective: To compare the clinical outcomes of ultrasonography-guided aspiration and sclerotherapy and laparoscopic deroofing for the treatment of simple renal cysts in children, providing evidence for clinical decision-making in the management of pediatric renal cysts.

Methods: A total of 49 patients with simple renal cysts were divided into two groups based on the treatment method: 29 patients (group 1) underwent laparoscopic deroofing, 20 patients (group 2) underwent ultrasonography-guided aspiration and sclerotherapy. The clinical efficacy differences between the two groups were compared.

Influence of Intraoperative Pain Management on Postoperative Delirium in Elderly Patients: A Prospective Single-Center Randomized Controlled Trial.

Introduction: Intraoperative analgesia and sedation are closely related to postoperative delirium. Depth of sedation based on bispectral index (BIS) guidance has been shown to reduce the occurrence of postoperative delirium (POD). However, the correlation between intraoperative analgesia levels and POD is unclear.

Comparison of warm sitz bath and electronic bidet with a lower-force water flow for postoperative management after hemorrhoidectomy (BIDLOW).

Aim: Electronic bidets can be a substitute for sitz baths, but no study has examined the use of electronic bidets to manage anal problems.

Methods: A randomized, controlled, single-blind, multicenter, parallel group trial was performed. Patients who underwent hemorrhoidectomy were randomly assigned (1:1) to use the electronic bidet or warm sitz baths for 7 days after hemorrhoidectomy.

Pain Management in Open Abdominal Aortic Aneurysm Repair: Potential Alternatives to Epidural Anesthesia.

Despite significant advances in endovascular techniques, open abdominal aortic aneurysm (AAA) repair continues to play an important role in vascular surgery. Many studies have described the advantages of epidural anesthesia combined with general anesthesia over general anesthesia alone as an analgesic method for open AAA repair. Several recent guidelines have recommended epidural anesthesia as the first option for pain management in open AAA repair.

Prioritising mental health in the perioperative period: understanding postoperative patterns in anxiety and depression through ecological momentary assessment.

A recent study in the British Journal of Anaesthesia examining trajectories of anxiety and depressive symptoms after diverse surgical procedures sheds light on an often overlooked, yet important, factor in postoperative recovery-mental health. The authors applied ecological momentary assessment to collect high-resolution data to identify and characterise a subgroup of vulnerable patients who experience worsening of psychological symptoms after surgery. The study prompts not only consideration of psychological factors, but also how best to leverage ecological momentary assessment to understand the perioperative experience.

The fine line between relief and risk: new insights into postoperative delirium.

There is a complex association between postoperative pain and postoperative delirium, which highlights the need for a more balanced approach to pain management that considers various risk factors. We emphasise the importance of comprehensive documentation and standardised monitoring to improve detection and management of postoperative delirium, ultimately enhancing patient outcomes. We advocate for a precision anaesthesia approach, which tailors care to individual patient profiles, as a potential solution to address these challenges.

Trends in comorbidities and complications among patients undergoing elective total hip and knee arthroplasty in the USA.

Background: Demand for total hip and knee arthroplasty procedures continues to rise. Ongoing changes in surgical care and patient populations require continued monitoring of outcome trends. Using nationwide data from the USA, we aimed to describe updated trends in patient and peri-operative care characteristics as well as complications among total hip and knee arthroplasty recipients.

Finding predictive factors of exercise adherence in randomized controlled trials on low back pain: an individual data re-analysis using machine learning techniques.

Objective: To identify predictors of adherence in supervised and self-administered exercise interventions for individuals with low back pain.

Design: Cohort study.

Setting: Rehabilitation.

Consumer perspectives of the group itself in group-delivered programs for people with chronic pain: a systematic review and meta-synthesis.

Group-delivered programs for chronic pain are evidence-based and frequently used. The contribution of group factors to outcomes is unclear and there are no integrated findings on consumer perceptions of the group itself in programs for people with chronic pain. The aim of this systematic review was to search and synthesise qualitative data specifically related to the group itself in studies investigating group-delivered programs for people with chronic pain (PROSPERO, CRD42023382447).

Utility of Radiographs for Asymptomatic Patients Following Primary Anatomic and Reverse Total Shoulder Arthroplasty.

Background: Radiographs are frequently obtained after total shoulder arthroplasty (TSA) to confirm implant placement and follow the status of the bone and prostheses; however, standardization of their use is lacking. There are concerns regarding frequent use of radiographs due to their cost and patient radiation exposure. The aim of this study is to assess the postoperative radiograph frequency and efficacy in primary anatomic and reverse total shoulder arthroplasty.

BLOOD PROTEOMICS AND MULTIMODAL RISK PROFILING of human volunteers after incision injury: a translational study for advancing Personalized Pain Management After Surgery.

A significant number of patients develop chronic pain after surgery, but prediction of those who are at risk is currently not possible. Thus, prognostic prediction models that include bio-psycho, social and physiological factors in line with the complex nature of chronic pain would be urgently required. Here, we performed a translational study in male volunteers before an experimental incision injury.

Adverse Events Associated With Surgically Implanted Temporomandibular Joint Devices.

Introduction: Temporomandibular disorder (TMD) is a common, yet potentially debilitating syndrome that negatively impacts patient quality of life. In patients with severe variants of TMD, temporomandibular joint (TMJ) devices have been utilized to replace the joint altogether. However, the risk profile and consequent cost-benefit ratio of these devices is largely debated.

The impact of body mass index on surgical complications in minimally invasive hysterectomy for uterine fibroids.

Research Question: We aimed to assess the impact of Body Mass Index (BMI) on 30-day postoperative complications in patients undergoing minimally invasive hysterectomy (MIH) for fibroids.

Design: Using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2012-2020), we analyzed major and minor 30-day postoperative complications, stratified by BMI, in patients with uterine fibroids who underwent MIH. Complications were stratified according to the Clavien-Dindo classification.

Patient Perspectives on the Value of Stereotactic Body Radiotherapy in the Management of Breast Cancer: The PERSPECTIVE Study.

Aims: Oligometastatic disease describes limited metastases amenable to therapy such as stereotactic body radiotherapy (SBRT). This study aims to understand which outcomes are most important to patients when considering SBRT as a treatment option. The insights gained will help inform future patient-directed trial endpoints and provide valuable guidance to clinicians supporting patients through their decision-making process.

Malignant transformation of a mature teratoma in the duodenum: A case report.

Introduction: Mature teratomas of the duodenum are extremely rare, with only five cases reported in the English literature and none documented in Vietnam. Malignant transformation within a mature teratoma presents a challenging scenario for diagnosis and management, requiring a nuanced approach to treatment.

Presentation Of Case: We report the first documented case of malignant transformation in a duodenal mature teratoma in Vietnam.

Giant odontoma: A systematic scoping review and case report.

Introduction And Importance: The most common type of odontogenic tumor is odontoma. Cases with at least one dimension (sagittal, axial, or coronal) ≥30 mm were categorized as giant odontomas. This study aimed to provide a scoping review of giant odontoma and present a case report.