scholarly journals THE USE OF A DIODE LASER IN THE TREATMENT OF DRUG-ASSOCIATED OSTEONECROSIS OF THE JAW (CLINICAL CASE)

2021 ◽  
Vol 17 (3) ◽  
pp. 64-68
Author(s):  
Natal'ya Vinogradova ◽  
Marina Haritonova ◽  
Konstantin L'vov
Keyword(s):  
Diode Laser ◽  
Medical Condition ◽  
Treatment Plan ◽  
Pain Syndrome ◽  
Staging System ◽  
Osteonecrosis Of The Jaw ◽  
Future Application ◽  
Autologous Plasma ◽  
First Case ◽  
Focus Of Infection

Object of research. Drug-associated osteonecrosis of the jaw is a complication of therapy with osteo-modifying agents. Several theories of its pathogenesis have been deduced, but there is no uniform treatment plan that would reduce the risk of relapse and allow timely prevention. The research aims to demonstrate the effectiveness of the intraoperative use of a diode laser in the treatment of drug-associated osteonecrosis of the jaw. Methodology. The article presents the case of treatment of 60-year-old patient with drug-associated osteonecrosis of the jaw. The underlying medical condition is Bence-Jones myeloma, Stage III on the Durie-Salmone Staging System, with the Th1 – Th12, L1 – L5 involvement. A laser surgical device with a diode laser with a wavelength of 980 nm, power of 0.1-20 W, with a continuous pulse type was used intraoperatively for ablation of residual granulations. An APRF clot was placed at the bottom of the wound. On the 5th and 10th days, autologous plasma injections were performed in the area of surgical treatment. Results. Low pain syndrome during the postoperative period, immediate agglutination, no relapse a month after surgery, closure of the cortical plates according to the control CT scan results. Conclusion. Thus, the first case of clinical use of a diode laser in the treatment of drug-associated osteonecrosis of the jaw has demonstrated its effectiveness. It cannot completely replace the traditional methods, but diode laser is an important auxiliary instrument which contributes to the rehabilitation of the focus of infection, stimulates reparative processes both in the mucous membrane and in the bone. Its future application in the treatment of drug-associated osteonecrosis of the jaw is promising and might prove its effectiveness in reducing the frequency of relapses.

Reduction of major amputations in the diabetic ischaemic foot: A strategy to "take control" with conservative care as well as revascularisation

VASA ◽  
2001 ◽  
Vol 30 (Supplement 58) ◽  
pp. 6-14 ◽  
Author(s):  
Edmonds ◽  
Foster
Keyword(s):  
Natural History ◽  
Treatment Plan ◽  
Staging System ◽  
Vascular Control ◽  
New Approach ◽  
Conservative Care ◽  
Arterial Bypass ◽  
Therapeutic Footwear ◽  
Frequent Problem

The diabetic ischaemic foot has become an increasingly frequent problem over the last decade. However, we report a new approach consisting of a basic classification, a simple staging system of the natural history and a treatment plan for each stage, within a multi-disciplinary framework. This approach of "taking control" consists of two parts: 1. long-term conservative care including debridement of ulcers (to obtain wound control), eradication of sepsis (micribiological control), and provision of therapeutic footwear (mechanical control), and 2. revascularisation by angioplasty and arterial bypass (vascular control). This approach has led to a 50% reduction in the rate of major amputations in patients attending with ischaemic ulceration and absent foot pulses from 1989 to 1999 (from 4.6% to 2.3% per year). Patients who underwent angioplasty increased from 6% to 13%. Arterial bypass similarly increased from 3% to 7% of cases. However, even with an increased rate of revascularisation, 80% of patients responded to conservative care alone. This,we conclude, is an essential part of the management of all patients with ischaemic feet.

scholarly journals Medication-Related Osteonecrosis of the Jaw (MRONJ): Are Antiresorptive Drugs the Main Culprits or Only Accomplices? The Triggering Role of Vitamin D Deficiency

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 561
Author(s):  
Luca Dalle Carbonare ◽  
Monica Mottes ◽  
Maria Teresa Valenti
Keyword(s):  
Vitamin D ◽  
Clinical Condition ◽  
Case Series ◽  
Osteonecrosis Of The Jaw ◽  
First Case ◽  
Vitamin D Levels ◽  
Exposed Bone ◽  
Antiresorptive Drugs ◽  
Almost All

Osteonecrosis of the jaw (ONJ) is a severe clinical condition characterized mostly but not exclusively by an area of exposed bone in the mandible and/or maxilla that typically does not heal over a period of 6–8 weeks. The diagnosis is first of all clinical, but an imaging feedback such as Magnetic Resonance is essential to confirm clinical suspicions. In the last few decades, medication-related osteonecrosis of the jaw (MRONJ) has been widely discussed. From the first case reported in 2003, many case series and reviews have appeared in the scientific literature. Almost all papers concerning this topic conclude that bisphosphonates (BPs) can induce this severe clinical condition, particularly in cancer patients. Nevertheless, the exact mechanism by which amino-BPs would be responsible for ONJ is still debatable. Recent findings suggest a possible alternative explanation for BPs role in this pattern. In the present work we discuss how a condition of osteomalacia and low vitamin D levels might be determinant factors.

The diabetic foot

2011 ◽  
pp. 1976-1989
Author(s):  
Michael Edmonds ◽  
Alethea. Foster
Keyword(s):  
Diabetic Foot ◽  
Early Recognition ◽  
Treatment Plan ◽  
Staging System ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Tissue Destruction ◽  
National Guidelines ◽  
International Consensus

At some time in their life, 15% of people with diabetes develop foot ulcers, which are highly susceptible to infection. This may spread rapidly leading to overwhelming tissue destruction and amputation: indeed, 85% of amputations are preceded by an ulcer and there is an amputation in a person with diabetes every 30 seconds throughout the world (1). Evidence-based protocols for diabetic foot ulcers have been developed (2), and diabetic foot programmes that have promoted a multidisciplinary approach to heal foot ulcers with aggressive management of infection and ischaemia have achieved a substantial decrease in amputation rates (3, 4). Furthermore, a reduction in amputations has been reported nationwide in diabetic patients throughout the Netherlands (5). Recently, a decrease in major amputation incidence has been reported in diabetic as well as in nondiabetic patients in Helsinki (6). These reports have stressed the importance of early recognition of the ‘at-risk’ foot, the prompt institution of preventive measures, and the provision of rapid and intensive treatment of foot infection and also evascularization in multidisciplinary foot clinics. Such measures can reduce the number of amputations in diabetic patients. Systematic reviews on prevention and treatment have been carried out, e.g. see Eldor et al. (7), and national guidelines have recently been formulated (8, 9). An International Consensus developed in 1999 was re-launched in revised form as an interactive DVD (10, 11) in 2007. This chapter outlines a simple classification of the diabetic foot into the neuropathic and neuroischaemic foot. It then describes a simple staging system of the natural history of the diabetic foot and a treatment plan for each stage. Successful management of the diabetic foot needs the expertise of a multidisciplinary team which should include physician, podiatrist, nurse, orthotist, radiologist, and surgeon working closely together, within the focus of a diabetic foot clinic.

scholarly journals Complex regional pain syndrome type II arising from a gunshot wound (GSW) associated with infective endocarditis and aortic valve replacement

2018 ◽  
pp. bcr-2018-224702
Author(s):  
Vinicius Tieppo Francio ◽  
Brandon Barndt ◽  
Chris Towery ◽  
Travis Allen ◽  
Saeid Davani
Keyword(s):  
Aortic Valve ◽  
Complex Regional Pain Syndrome ◽  
Gunshot Wound ◽  
Pain Syndrome ◽  
Syndrome Type ◽  
Type Ii ◽  
Thoracic Sympathectomy ◽  
Arm Pain ◽  
First Case ◽  
Pain Status

A 34-year-old man with a history of gunshot wound (GSW) to the right upper chest developed secondary aortic valve endocarditis (AVE) and was treated with an artificial valve placement (AVP). Three months after, he presented to an outpatient pain management clinic right arm pain and was diagnosed with complex regional pain syndrome type II (CRPS II). The patient underwent a diagnostic sympathetic ganglion block, before undergoing endoscopic thoracic sympathectomy surgery. Successful outcomes revealed decreased pain, opioid utilisation and improved tolerance to therapy and activities of daily living. To our knowledge, this is the first case reporting CRPS II arising from a GSW complicated by AVE followed by AVP, which emphasises how unforeseen syndromes can arise from the management of seemingly unrelated pathology. This case demonstrates the importance of timely and proper diagnosis of uncharacterised residual pain status post-trauma and differential diagnosis and management of chronic pain syndromes.

Spinal Cord Stimulation for Chronic Pain Relief: First Experience in Baltics

2011 ◽  
Vol 11 (1) ◽  
pp. 180-181
Author(s):  
Iveta Golubovska ◽  
Aleksejs Miscuks ◽  
Vitolds Jurkevics ◽  
Sarmite Skaida
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Pain Relief ◽  
Low Income ◽  
Spinal Cord Stimulation ◽  
Pain Syndrome ◽  
Neuropathic Pain Syndrome ◽  
Patient Status ◽  
First Case

Spinal Cord Stimulation for Chronic Pain Relief: First Experience in BalticsWe report the first case of spinal cord stimulator implantation in Baltics to patient with massive posttraumatic plexus lumbosacralis dxtr lesion, severe neuropathic pain syndrome and drug addiction problems. Follow-up time is 6 month since December 2011 and we have observed an obvious clinical and social improvement in patient status. Besides significant pain relief she has got employed and is tax payer instead of low-income person.

Computational fluid dynamic study on the tribological performance of dimple-textured surface fabricated using the turning process

2019 ◽  
Vol 71 (4) ◽  
pp. 594-602 ◽  
Author(s):  
Haniff Abdul Rahman ◽  
Jaharah A. Ghani ◽  
Wan Mohd Faizal Wan Mahmood ◽  
Mohammad Rasidi Mohammad Rasani
Keyword(s):  
Pressure Distribution ◽  
Load Capacity ◽  
Surface Texturing ◽  
Tribological Performance ◽  
Future Application ◽  
Textured Surface ◽  
Turning Process ◽  
Equal Distribution ◽  
Content Type ◽  
First Case

Purpose This study aims to simulate the influence of surface texturing produced via turning process toward pressure distribution and load capacity generation using computational fluid dynamics (CFD). Design/methodology/approach The dimple geometry was obtained via turning process, to be used for future application on piston skirt surfaces. Two cases were studied: a preliminary study using single periodic dimple assuming linear dimple distribution and an application study using multiple periodic dimples to address actual dimple orientation following the turning process. Findings For the first case, the dimple was proven to generate load capacity with regard to untextured surface, owing to the asymmetric pressure distribution. Increasing the Reynolds number, dimple width and dimple depth was found to increase load capacity. For the second case, although load capacity increases via surface texturing, the value was 97.4 per cent lower relative to the first case. This confirmed the importance of doing multiple dimple simulations for real applications to achieve more realistic and accurate results. Originality/value A new concept of dimple fabrication using a low-cost turning process has been developed, with a potential to increase the tribological performance under hydrodynamic lubrication. Previous CFD simulations to simulate these benefits have been done using a single periodic dimple, assuming equal distribution array between dimples. However, due to the different orientations present for dimples produced using turning process, a single periodic dimple simulation may not be accurate, and instead, multiple dimple simulation is required. Therefore, present research was conducted to compare the results between these two cases and to ensure the accuracy of CFD simulation for this type of dimple.

A case report of wireless peripheral nerve stimulation for complex regional pain syndrome type-I of the upper extremity: 1 year follow up

2019 ◽  
Vol 19 (4) ◽  
pp. 829-835 ◽  
Author(s):  
Daniel Herschkowitz ◽  
Jana Kubias
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Peripheral Nerve ◽  
Upper Extremity ◽  
Nerve Stimulation ◽  
Pain Syndrome ◽  
Peripheral Nerve Stimulation ◽  
Type I ◽  
First Case

Abstract Background Complex regional pain syndrome (CRPS) is a chronic disabling painful disorder with limited options to achieve therapeutic relief. CRPS type I which follows trauma, may not show obvious damage to the nervous structures and remains dubious in its pathophysiology and also its response to conservative treatment or interventional pain management is elusive. Spinal cord and dorsal root ganglion stimulation (SCS, DRGS) provide good relief, mainly for causalgia or CRPS I of lower extremities but not very encouraging for upper extremity CRPS I. we reported earlier, a case of CRPS I of right arm treated successfully by wireless peripheral nerve stimulation (WPNS) with short term follow up. Here we present 1-year follow-up of this patient. Objective To present the first case of WPNS for CRPS I with a year follow up. The patient had minimally invasive peripheral nerve stimulation (PNS), without implantable pulse generator (IPG) or its accessories. Case report This was a case of refractory CRPS I after blunt trauma to the right forearm of a young female. She underwent placement of two Stimwave electrodes (Leads: FR4A-RCV-A0 with tines, Generation 1 and FR4A-RCV-B0 with tines, Generation 1) in her forearm under intraoperative electrophysiological and ultrasound guidance along radial and median nerves. This WPNS required no IPG. At high frequency (HF) stimulation (HF 10 kHz/32 μs, 2.0 mA), patient had shown remarkable relief in pain, allodynia and temperature impairment. At 5 months she started driving without opioid consumption, while allodynia disappeared. At 1 year follow up she was relieved of pain [visual analogue scale (VAS) score of 4 from 7] and Kapanji Index (Score) improved to 7–8. Both hands look similar in color and temperature. She never made unscheduled visits to the clinic or visited emergency room for any complications related to the WPNS. Conclusions CRPS I involving upper extremity remain difficult to manage with conventional SCS or DRGS because of equipment related adverse events. Minimally invasive WPNS in this case had shown consistent relief without any complications or side effects related to the wireless technology or the technique at the end of 1 year. Implications This is the first case illustration of WPNS for CRPS I, successfully treated and followed up for 1 year.

scholarly journals The Management of Unstable Cervical Spine Injuries

2014 ◽  
Vol 5 ◽  
pp. CMTIM.S12263
Author(s):  
Venu M. Nemani ◽  
Han Jo Kim
Keyword(s):  
Cervical Spine ◽  
Medical Condition ◽  
Treatment Plan ◽  
Neurological Status ◽  
Patient Specific ◽  
X Rays ◽  
Mechanism Of Injury ◽  
Imaging Studies ◽  
Cervical Spine Injuries ◽  
Spine Injuries

Injuries to the cervical spine can cause potentially devastating morbidity and even mortality. In this review we discuss the anatomy and biomechanics of the cervical spine. The evaluation and treatment of cervical spine injuries begins with the prompt immobilization of suspected injuries in the field. Once an assessment of the patient's neurological status is made, imaging studies are obtained, which can include X-rays, CT, and MRI. Careful scrutiny of the imaging studies for bony and/or ligamentous injury allows the physician to determine the mechanism of injury, which guides treatment. The ultimate treatment plan can consist of non-operative or operative management, and depends on patient specific factors (medical condition and neurological status), the mechanism of injury, and the resultant degree of instability. With prompt diagnosis and appropriate management, the morbidity of these injuries can be minimized.

scholarly journals Still's Disease and Recurrent Complex Regional Pain Syndrome Type-I: The First Description

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
César Faillace ◽  
Jozélio Freire de Carvalho
Keyword(s):  
Neuropathic Pain ◽  
Complex Regional Pain Syndrome ◽  
Skin Color ◽  
Pain Syndrome ◽  
Type I ◽  
Still’S Disease ◽  
Chronic Neuropathic Pain ◽  
Still's Disease ◽  
First Case ◽  
Psychiatric Conditions

Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder characterized by neuropathic pain associated with local edema and changes suggestive of autonomic involvement such as altered sweating, skin color, and skin temperature of the affected region. CRPS was described associated with several diseases, such as trauma, psychiatric conditions, and cancer. However, no case associated with Still's disease has been previously described. In this paper, the authors describe the first case of CRPS associated with Still's disease.

Osteonecrose dos maxilares associada ao uso de bifosfonatos

2020 ◽  
Vol 11 (1) ◽  
pp. 25
Author(s):  
Paula Strauch Ferreira Lessa Santos ◽  
Antônio Lucindo Pinto de Campos Sobrinho
Keyword(s):  
Treatment Protocol ◽  
Osteonecrosis Of The Jaw ◽  
The Body ◽  
Skeletal Metastases ◽  
Present Moment ◽  
Adequate Treatment ◽  
Maxillary Bone ◽  
Dental Patients ◽  
First Case ◽  
Antiresorptive Drugs

Endogenous pyrophosphate is a substance responsible for inhibiting bone resorption in the body, but can not be used as a therapeutic agent in the treatment of diseases, as it rapidly undergoes enzymatic hydrolysis. Biphosphonates, the synthetic analogues of this substance, are potent inhibitors of osteoclastic activity and are chosen as the first treatment option for several diseases that relate to loss of bone mass such as osteoporosis, Paget's Disease, Skeletal Metastases and Multiple Myeloma. The first case of biphosphonate-related osteonecrosis of the jaw (BRONJ) was presented in 2003, and since then several studies have been carried out with the objective of understanding the mechanism that leads these compounds to induce a maxillary bone necrosis. Recently, new cases of BRONJ associated with another class of antiresorptive drugs, such as Desonumab, have been drawing attention. This paper aims to discuss, through a literature review, the knowledge about the action mechanism of these drugs and their relationship in the care of dental patients, seeking new updates that may help in the better understanding of their etiopathogeny. To do this study, a bibliographic survey was made regarding the occurrence of BRONJ, using Pubmed, Scielo, Google Scholar and Medline as search bases from 2001 to 2018. Through this study, it can be concluded that although several discoveries have been made since the appearance of the pathology until the present moment, a lot of research still has to be done to arrive at a adequate treatment protocol.

Sign in / Sign up

Export Citation Format

Share Document