scholarly journals Nervus intermedius and the surgical management of geniculate neuralgia

2019 ◽  
Vol 131 (2) ◽  
pp. 343-351 ◽  
Author(s):  
Maria Peris-Celda ◽  
Soliman Oushy ◽  
Avital Perry ◽  
Christopher S. Graffeo ◽  
Lucas P. Carlstrom ◽  
...  
Keyword(s):  
Pain Syndrome ◽  
Symptomatic Improvement ◽  
Sensory Innervation ◽  
Complex Nature ◽  
Simultaneous Treatment ◽  
Repeat Surgery ◽  
Pain Outcomes ◽  
Cranial Neuralgias ◽  
Almost All ◽  
Nervus Intermedius

OBJECTIVEGeniculate neuralgia (GN) is an uncommon craniofacial pain syndrome attributable to nervus intermedius (NI) dysfunction. Diagnosis and treatment can be challenging, due to the complex nature of ear sensory innervation, resulting in clinical overlap with trigeminal neuralgia (TN) and glossopharyngeal neuralgia (GPN).METHODSA retrospective review of a prospective neurosurgical database at our institution was performed, 2000–2017, with a corresponding systematic literature review. Pain outcomes were dichotomized as unfavorable for unchanged/worsened symptoms versus favorable if improved/resolved. Eight formalin-fixed brains were examined to describe NI at the brainstem.RESULTSEleven patients were surgically treated for GN—9 primary, 2 reoperations. The median age was 48, 7 patients were female, and the median follow-up was 11 months (range 3–143). Seven had ≥ 2 probable cranial neuralgias. NI was sectioned in 9 and treated via microvascular decompression (MVD) in 2. Five patients underwent simultaneous treatment for TN (4 MVD; 1 rhizotomy) and 5 for GPN (3 MVD; 2 rhizotomy). Eleven reported symptomatic improvement (100%); 8 initially reported complete resolution (73%). Pain outcomes at last contact were favorable in 8 (73%)—all among the 9 primary operations (89% vs 0%, p = 0.054). Six prior series reported outcomes in 111 patients.CONCLUSIONSGN is rare, and diagnosis is confounded by symptomatic overlap with TN/GPN. Directed treatment of all possible neuralgias improved pain control in almost all primary operations. Repeat surgery seems a risk factor for an unfavorable outcome. NI is adherent to superomedial VIII at the brainstem; the intermediate/cisternal portion is optimal for visualization and sectioning.

scholarly journals  Macedonian livestock, dairy and grain sectors and the EU accession impact

2013 ◽  
Vol 59 (No. 3) ◽  
pp. 125-133
Author(s):  
A. Kotevska ◽  
D. Dimitrievski ◽  
E. Erjavec
Keyword(s):  
Model Simulation ◽  
Positive Development ◽  
Complex Nature ◽  
Baseline Scenario ◽  
The European Union ◽  
Eu Accession ◽  
The Republic ◽  
Almost All ◽  
The Impact ◽  
The Eu

The Republic of Macedonia is in the process of integrating into the European Union (EU) and adjusting its policies through reforms in policy, regulations and institutions. This paper attempts to provide an answer to the question: what would be the impact on the Macedonian livestock, dairy and grain sectors of Macedonia integrating into the EU. In order to forecast the impact of the EU accession, the research uses the partial equilibrium model as a comprehensive tool for modelling the complex nature of the agricultural markets. The model simulation foresees the changes of the modelled sub-sectors in production, net-trade and income. The baseline scenario predicts a positive development for almost all selected commodities, with the exception of the beef sector, which is highly uncompetitive prior to the accession. Three EU accession scenarios foresee positive developments in the beef, lamb and cow’s milk markets, while a negative development is expected in the pig meat and grains markets.  

scholarly journals A Systematic Review of Biological Mechanisms and Chronic Pain Outcomes During Stress Reduction Interventions

2020 ◽  
Vol 22 (2) ◽  
pp. 205-216
Author(s):  
Katherine M. Bernier Carney ◽  
Erin E. Young ◽  
Jessica W. Guite ◽  
Angela R. Starkweather
Keyword(s):  
Chronic Pain ◽  
Stress Reduction ◽  
Experimental Studies ◽  
Complex Nature ◽  
Biological Mechanisms ◽  
Study Selection ◽  
Pain Outcomes ◽  
Quasi Experimental ◽  
Pain Trajectories ◽  
Meta Analyses

Background: Nonpharmacologic stress reduction interventions provide an opportunity to modify chronic pain trajectories; however, the biological mechanisms underlying these interventions are poorly understood. Objectives: To examine clinical literature published in 2012–2018 with the goals of (1) identifying which biological mechanisms or biomarkers are currently being measured in nonpharmacologic stress reduction intervention studies for individuals with chronic pain and (2) evaluating the evidence to determine whether these stress reduction interventions lead to changes in (a) pain outcomes and/or (b) measured biomarkers. Data sources: Scientific articles in the electronic databases PubMed/Medline, Cumulative Index of Nursing and Allied Health Literature, PsychINFO, and SCOPUS following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Study selection: Randomized controlled trials and quasi-experimental studies that recruited subjects with a chronic pain condition, examined a relationship between a nonpharmacologic stress reduction intervention and pain-related outcome(s), and included measurement of a biomarker. Results: The 13 articles that met inclusion criteria spanned four nonpharmacologic stress reduction categories: mindfulness-based stress reduction, physical exercise, manual therapies, and biofeedback. Methods for studying biomarkers included measuring biological samples, neurological function, and autonomic control. Although all studies investigated both biological measures and pain outcomes, only three demonstrated an association between the biomarker(s) and pain-related outcomes. Conclusions: The results of this review highlight the complex nature of stress–pain relationships and the lack of rigorous clinical research identifying specific stress-related biological factors that modulate pain outcomes. Stress reduction interventions remain a favorable method for symptom management in patients living with chronic pain, but consistency in study measures and design is needed for robust evaluation.

scholarly journals Digital Game Based Learning of Stack Data Structure Using Question Prompts

2019 ◽  
Vol 13 (07) ◽  
pp. 90 ◽  
Author(s):  
Rosni Ramle ◽  
D'oria Islamiah Rosli ◽  
Shelena Soosay Nathan ◽  
Mazniha Berahim
Keyword(s):  
Information Technology ◽  
Data Structure ◽  
Learning Strategies ◽  
Positive Outcome ◽  
Complex Nature ◽  
Game Based Learning ◽  
Job Interviews ◽  
Question Prompts ◽  
Adopted Model ◽  
Almost All

<p class="0abstract">Data structure and algorithm is an important course in computer science and information technology programs, applied in almost all courses. Failure to master it will affect student's academic performance during study, getting job interviews, passing job interviews, and create an inefficient information technology worker. However, learning data structure is a worldwide problem because of its complex nature. Gameful visualization of data structures’ algorithms has been gaining momentum as it resulted in increased motivation, engagement and learning outcome. But effectiveness of game-based learning could be hindered if improper learning strategies used. Instructional scaffold in game-based learning in the form of question prompts have been found to be the most effective way to scaffold self-learn in computer-based learning. Thus, a game-based learning of stack data structure using question prompts was designed, developed and tested based on an adopted model to help students understand the algorithms of stack’s insert and delete operations for array implementation with gameplay that could create meaningful learning. A pre-game and post-game test was conducted to compare students’ performance on the topic. Results indicated a generally positive outcome.</p>

Patient outcomes in schizophrenia I: correlates with sociodemographic variables, psychopathology, and side effects

2005 ◽  
Vol 20 (5-6) ◽  
pp. 386-394 ◽  
Author(s):  
Alex Hofer ◽  
Susanne Baumgartner ◽  
Monika Edlinger ◽  
Martina Hummer ◽  
Georg Kemmler ◽  
...  
Keyword(s):  
Side Effects ◽  
Patient Outcomes ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Symptomatic Improvement ◽  
Complex Nature ◽  
Cognitive Symptoms ◽  
Cross Sectional ◽  
Female Sex ◽  
Needs For Care

AbstractObjectiveThe present cross-sectional study examined the relationships of psychopathology, side effects, and sociodemographic factors with treatment outcomes in terms of patients' quality of life (QOL), functioning, and needs for care.MethodSixty outpatients with chronic schizophrenia who had been treated with either clozapine or olanzapine for at least 6 months were investigated.ResultsMost psychopathological symptoms as well as psychic side effects, weight gain, and female sex were associated with lower QOL, while cognitive symptoms correlated with better QOL. Female sex, cognitive symptoms, and parkinsonism negatively influenced occupational functioning, and negative symptoms determined a lesser likelihood of living independently. Age, education, depression/anxiety, negative symptoms, and psychic side effects were predictors of patients' needs for care.ConclusionOur results highlight the complex nature of patient outcomes in schizophrenia. They reemphasize the need of targeting effectiveness, i.e. both symptomatic improvement as well as drug safety, in such patients.

scholarly journals An Interventional Pain Algorithm for the Treatment of Postmastectomy Pain Syndrome: A Single-Center Retrospective Review

Pain Medicine ◽  
2020 ◽  
Author(s):  
Ajax Yang ◽  
Danielle Nadav ◽  
Aron Legler ◽  
Grant H Chen ◽  
Lee Hingula ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Peripheral Nerve ◽  
Breast Cancer Survivors ◽  
Pain Syndrome ◽  
Sensory Innervation ◽  
Injection Pain ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Medication Consumption ◽  
The Mean

Abstract Objective Breast cancer is the most common female malignancy worldwide. Breast surgery and adjuvant oncological therapies are often required to increase survival. Treatment-related pain may persist and evolve into postmastectomy pain syndrome (PMPS) in a significant subset of breast cancer survivors. In this retrospective investigation, we will present our experience in applying an interventional algorithmic approach to treat PMPS. Design A retrospective study. Setting An academic cancer hospital. Subjects Adult females with PMPS diagnosis. Methods We reviewed 169 records with the diagnosis of PMPS from 2015 to 2019 within our health system. Pre- and post-injection pain scores, relief duration, and medication usage changes were collected. The decision to perform each procedure was based on the anatomic location of the painful area with the corresponding peripheral sensory innervation. Decision-making flow diagrams were created to present our experience in managing PMPS beyond peripheral nerve blocks. Results Ultrasound-guided peripheral nerve block results (n=350) were analyzed. The mean baseline pain score was 7, compared with the post-treatment mean score of 3 (95% confidence interval: 3.58 to 3.98, P = 0.0001). Among the responders, the mean pain relief duration was 45 days, with a median of 84 days. Opioid medication consumption was reduced by 11% (t = 0.72, P = 0.47). Conclusions Ultrasound-guided nerve blocks of this area could be performed safely and effectively after breast surgeries. We also present our proposed algorithm to provide a stepwise application for selecting the appropriate therapies in the management of more complex PMPS.

scholarly journals Fifteen Shades of Grey: Combined Analysis of Genome-Wide SNP Data in Steppe and Mediterranean Grey Cattle Sheds New Light on the Molecular Basis of Coat Color

Genes ◽  
2020 ◽  
Vol 11 (8) ◽  
pp. 932 ◽  
Author(s):  
Gabriele Senczuk ◽  
Lorenzo Guerra ◽  
Salvatore Mastrangelo ◽  
Claudia Campobasso ◽  
Kaouadji Zoubeyda ◽  
...  
Keyword(s):  
Candidate Genes ◽  
Coat Color ◽  
Snp Array ◽  
Complex Nature ◽  
Cattle Breeds ◽  
Snp Data ◽  
Genome Wide ◽  
Almost All ◽  
Pleiotropic Functions ◽  
Fst Outlier

Coat color is among the most distinctive phenotypes in cattle. Worldwide, several breeds share peculiar coat color features such as the presence of a fawn pigmentation of the calf at birth, turning over time to grey, and sexual dichromatism. The aim of this study was to search for polymorphisms under differential selection by contrasting grey cattle breeds displaying the above phenotype with non-grey cattle breeds, and to identify the underlying genes. Using medium-density SNP array genotype data, a multi-cohort FST-outlier approach was adopted for a total of 60 pair-wise comparisons of the 15 grey with 4 non-grey cattle breeds (Angus, Limousin, Charolais, and Holstein), with the latter selected as representative of solid and piebald phenotypes, respectively. Overall, more than 50 candidate genes were detected; almost all were either directly or indirectly involved in pigmentation, and some of them were already known for their role in phenotypes related with hair graying in mammals. Notably, 17 relevant genes, including SDR16C5, MOS, SDCBP, and NSMAF, were located in a signal on BTA14 convergently observed in all the four considered scenarios. Overall, the key stages of pigmentation (melanocyte development, melanogenesis, and pigment trafficking/transfer) were all represented among the pleiotropic functions of the candidate genes, suggesting the complex nature of the grey phenotype in cattle.

scholarly journals Assessment of the Short-Term Effectiveness of Kinesiotaping and Trigger Points Release Used in Functional Disorders of the Masticatory Muscles

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Danuta Lietz-Kijak ◽  
Łukasz Kopacz ◽  
Roman Ardan ◽  
Marta Grzegocka ◽  
Edward Kijak
Keyword(s):  
Pain Syndrome ◽  
Trigger Points ◽  
Masticatory Muscles ◽  
The Body ◽  
Complex Nature ◽  
Self Healing ◽  
Functional Disorders ◽  
Myofascial Trigger Points ◽  
Analgesic Effects ◽  
Therapeutic Problem

Chronic face pain syndrome is a diagnostic and therapeutic problem for many specialists, and this proves the interdisciplinary and complex nature of this ailment. Physiotherapy is of particular importance in the treatment of pain syndrome in the course of temporomandibular joint functional disorders. In patients with long-term dysfunction of masticatory muscles, the palpation examination can localize trigger points, that is, thickening in the form of nodules in the size of rice grains or peas. Latent trigger points located in the muscles can interfere with muscular movement patterns, cause cramps, and reduce muscle strength. Because hidden trigger points can spontaneously activate, they should be found and released to prevent further escalation of the discomfort. Kinesiotaping (KT) is considered as an intervention that can be used to release latent myofascial trigger points. It is a method that involves applying specific tapes to the patient’s skin in order to take advantage of the natural self-healing processes of the body. The aim of the study was to evaluate the effect of the kinesiotaping method and trigger points inactivation on the nonpharmacological elimination of pain in patients with temporomandibular disorders. The study was conducted in 60 patients (18 to 35 years old). The subjects were randomly divided into two subgroups of 30 people each. Group KT (15 women and 15 men) were subjected to active kinesiotaping application. Group TrP, composed of 16 women and 14 men, was subjected to physiotherapy with the release of trigger points by the ischemic compression method. The results show that the KT method and TrP inactivation brought significant therapeutic analgesic effects in the course of pain-related functional disorders of the muscles of mastication. The more beneficial outcomes of the therapy were observed after using the KT method, which increased the analgesic effect in dysfunctional patients.

Sign in / Sign up

Export Citation Format

Share Document