In seeing chronic pain pateints one is left with feeling there is more to it the just structural problems. Now a single gene variant show its effects.
Post Chest Surgery Pain Help – Intercostal Neurolysis
Thoracotomies have a horrible record for leaving people with significant pains. Freeing up scarred in nerves (neurolysis) offers respite.
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Agents for Stage 4 Prostate Cancers
Since 2013 when 223Radium-dichloride was FDA approved, there has been some excitement in literature over its benefits in stage 4 prostate cancer. Conclusion of article was ” Ra also has demonstrated to increase overall survival in patients and to delay adverse skeletal events”. Biphophonates like Zoledronic acid and Denosumab can help with the pain of prostate bone cancer.
But the greatest excitement is with use of “225Ac-PSMA-617” – radioactive tagged prostate targetted compound that can induce remission of stage 4 prostate cancer. Sadly, availability may be lacking. Additionally, finding in subjects with oligomets(few metastastes) high dose radiation can induce blood changes similar to a vaccination and bring 1/2 of cases into remission for past year of trial.
Tooth Pain Without Reason – Botulinum it
Continuous pain of tooth without obvious cause is called Atypical Odontalgia. Up until now it has been poorly treated. Now injection of botulinum can achieve at least 50% reduction in pain. It requires injecting gums between affected teeth and areas of referral – including lips and palate if necessary.
Are Medicenter Doctors Getting too Stupid to Stitch Wounds?
Had patient who required ONE stitch for a finger injury not find a medicenter that would stitch it- She ended up using a steristrip… What gives?
Early Osteonecrosis Hip Helped by IV Pamidronate
When I see Osteonecrosis cases, I’ve always wondered if IV Biphosphonates could have helped. Apparently so, for this 27 year old. They used Pamidronate 45 mg daily for 3 days monthly. Only did 2 cycles and got good results.
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Neuropathic Coccygodynia helped by Steroid Ganglion Impar Block
Longstanding(> 3 months) coccygodynia was helped by transsacrococcygeal ganglion Impar block with 3 mL of 0.5% bupivacaine, 2 mL saline, and 1 mL (40 mg) of methylprednisolone .
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Neck or Back Pain with MRI Modic Changes Could be Infection
Cases scheduled for neck surgery were classified as having modic type I changes and biopsied for Propionibacterium Acnes Infection during surgery.
no modic changes – 20% were positive for p.acne infection
modic changes – 54% positive were positive for p.acne infection
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Statin Use and Knee Pains
over 5 year use showed the following:
rosuvastatin – slight increase risk of pain 1.12X
atrovastatin – slight decrease in pain X 0.95
Could Metformin Prevent Opioid Tolerance?
Metformin inhibits mTOR signalling pathway which helps with its anti-cancer properties. Blocking mTOR also seems to reduce tolerance. Tolerance can be seen in tissue lines by elevated nitrite levels. Metformin prevent nitrite elevation with both methadone and morphine.
I don’t know why actually studies in diabetics on metformin re opioids have not been done but implications from basic science suggests it might be helpful in preventing tolerance,
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