scholarly journals A Case Report of Essential Tremors Treated with Yeokhan-san

2021 ◽  
Vol 42 (5) ◽  
pp. 1102-1108
Author(s):  
Da-jung Ha ◽  
Tae-young Huh ◽  
Sang-eun Park
Keyword(s):  
Case Report ◽  
Essential Tremor ◽  
Visual Analog Scale ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Visual Analog Scale Score ◽  
Analog Scale ◽  
Hand Tremor ◽  
Essential Tremors ◽  
Clinical Rating Scale

Objective: This report describes the case of a patient with essential tremors of the mouth and hands, which were improved by Yeokhan-san treatment.Methods: To relieve the symptoms, Korean medicine treatments, including Yeokhan-san, Ohaeng-Hwa acupuncture, and electronic moxibustion, were performed. To evaluate the effects of the treatments, the visual analog scale and Fahn-Tolosa-Marin clinical rating scale for tremor were used.Results: After the treatment, the patient's clinical symptoms were improved. The visual analog scale score decreased from 10 to 2 for the hand tremor and from 10 to 1 for the mouth tremor. The Fahn-Tolosa-Marin tremor scores decreased from 3 to 1 for both the hand and mouth tremors.Conclusions: The present case suggests that Yeokhan-san and Ohaeng-Hwa acupuncture are effective for the treatment of essential tremor.

Treating traumatic thoracolumbar spine fractures using minimally invasive percutaneous stabilization plus balloon kyphoplasty: a 102-patient series

2021 ◽  
pp. neurintsurg-2020-017238
Author(s):  
Henri Salle ◽  
Alexandre Meynard ◽  
Emilie Auditeau ◽  
Clément Gantois ◽  
Aymeric Rouchaud ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Open Surgery ◽  
Body Height ◽  
Thoracolumbar Spine ◽  
Visual Analog Scale Score ◽  
Posterior Wall ◽  
Balloon Kyphoplasty ◽  
Expected Improvement ◽  
Thoracolumbar Fractures ◽  
Analog Scale

BackgroundThere is no consensus on the treatment for spinal injuries resulting in thoracolumbar fractures without neurological impairment. Many trauma centers are opting for open surgery rather than a neurointerventional approach combining posterior percutaneous short fixation (PPSF) plus balloon kyphoplasty (BK).ObjectiveTo assess the safety and efficacy of PPSF+BK and to estimate the expected improvement by clarifying the factors that influence improvement.MethodsWe retrospectively reviewed patients who underwent PPSF+BK for the treatment of single traumatic thoracolumbar fractures from 2007 to 2019. Kyphosis, loss of vertebral body height (VBH), clinical and functional outcomes including visual analog scale and Oswestry disability index were assessed. We examined the overall effects in all patients by constructing a linear statistical model, and then examined whether efficacy was dependent on the characteristics of the patients or the fractures.ResultsA total of 102 patients were included. No patient experienced neurological worsening or wound infections. The average rates of change were 74.4% (95% CI 72.6% to 76.1%) for kyphosis and 85.5% (95% CI 84.4% to 86.6%) for VBH (both p<0.0001). The kyphosis treatment was more effective on Magerl A3 and B2 fractures than on those classified as A2.3, as well as for fractures with slight posterior wall protrusion on the spinal canal. A higher postoperative visual analog scale score was predictive of poorer outcome at 1 year.ConclusionsThis is the largest series reported to date and confirms and validates this surgical treatment. All patients exhibited improved kyphosis and restoration of VBH. We advise opting for this technique rather than open surgery.

scholarly journals Pruritus is common in patients with chronic liver disease and is improved by nalfurafine hydrochloride

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shuhei Yoshikawa ◽  
Takeharu Asano ◽  
Mina Morino ◽  
Keita Matsumoto ◽  
Hitomi Kashima ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Scale Score ◽  
Visual Analog Scale ◽  
Visual Analog Scale Score ◽  
Chronic Liver ◽  
Common Complication ◽  
Analog Scale

AbstractPruritus is known to be a common complication in hepatitis patients, but the exact frequency and degree are not fully elucidated. Thus, we evaluated pruritus of 450 patients with chronic liver disease at our hospital. Pruritus was observed in 240 (53%) of the patients. Pruritus was significantly associated with males (OR = 1.51, P = 0.038) and patients with alkaline phosphatase (ALP) ≥ 200 U/L (OR = 1.56, P = 0.0495) and was significantly less in HBsAg-positive patients (OR = 0.449, P = 0.004). Seasonally, there was no difference in the frequency of pruritus between summer and winter. Of the 24 refractory pruritus patients treated with nalfurafine, 17 (71%) indicated improvement of itch, which is defined as a decrease in the visual analog scale score ≥ 30 mm. Pruritus was improved by nalfurafine both during daytime and nighttime in the Kawashima’s scores evaluation. All patients who received nalfurafine exhibited improved Kawashima’s scores ≥ 1 point during the daytime or nighttime. In conclusion, pruritus occurred in > 50% of patients with chronic liver disease, and predictors of pruritus were males and ALP ≥ 200 U/L. Nalfurafine may be useful for pruritus, regardless of whether daytime or nighttime.

scholarly journals A comparison of pain registration by Visual Analog Scale and Numeric Rating Scale – a cross-sectional study of primary triage registration

2020 ◽  
Author(s):  
Jofrid Kollltveit ◽  
Malin Osaland ◽  
Marianne Reimers ◽  
Magnus Berle
Keyword(s):  
Emergency Department ◽  
Visual Analog Scale ◽  
Rating Scale ◽  
Emergency Admission ◽  
Numeric Rating Scale ◽  
University Hospital ◽  
Analog Scale ◽  
Cross Sectional ◽  
Significant Difference ◽  
Numeric Rating

BackgroundPain is a subjective sensation; self-reporting is important for quantifying pain intensity. There are several different validated tools for this, such as Visual Analog Scale and Numeric Rating Scale. In the clinic, these terms are often used as equivalent. The objective of this study was to examine correlation and agreement between the pain registration tools in triage in an emergency department.Materials and MethodsThe study was performed in the Department of Emergency Medicine at Haukeland University Hospital in the period June-August 2019. We registered the pain score with two tools in 200 unselected patients in emergency admission with pain. In addition, we registrered gender, age, triage and general department affiliation.ResultsWe found a strong correlation between the pain registration tools by Spearmans correlation test (rho=0,930, p<0,001). There were no significant difference between the pain registration tools within the subgroups. Bland-Altman analysis show agreement between the two pain registration tools.ConclusionsIn an Emergency Department triage is it acceptable to use Visual Analog Scale and Numeric Rating Scale as equivalent, as long as the correct terminology is used.

Three-year follow-up of prospective trial of focused ultrasound thalamotomy for essential tremor

Neurology ◽  
2019 ◽  
Vol 93 (24) ◽  
pp. e2284-e2293 ◽  
Author(s):  
Casey H. Halpern ◽  
Veronica Santini ◽  
Nir Lipsman ◽  
Andres M. Lozano ◽  
Michael L. Schwartz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Essential Tremor ◽  
Focused Ultrasound ◽  
Rating Scale ◽  
Prospective Trial ◽  
Postural Tremor ◽  
Hand Tremor

ObjectiveTo test the hypothesis that transcranial magnetic resonance–guided focused ultrasound (tcMRgFUS) thalamotomy is effective, durable, and safe for patients with medication-refractory essential tremor (ET), we assessed clinical outcomes at 3-year follow-up of a controlled multicenter prospective trial.MethodsOutcomes were based on the Clinical Rating Scale for Tremor, including hand combined tremor–motor (scale of 0–32), functional disability (scale of 0–32), and postural tremor (scale of 0–4) scores, and total scores from the Quality of Life in Essential Tremor Questionnaire (scale of 0–100). Scores at 36 months were compared with baseline and at 6 months after treatment to assess for efficacy and durability. Adverse events were also reported.ResultsMeasured scores remained improved from baseline to 36 months (all p < 0.0001). Range of improvement from baseline was 38%–50% in hand tremor, 43%–56% in disability, 50%–75% in postural tremor, and 27%–42% in quality of life. When compared to scores at 6 months, median scores increased for hand tremor (95% confidence interval [CI] 0–2, p = 0.0098) and disability (95% CI 1–4, p = 0.0001). During the third follow-up year, all previously noted adverse events remained mild or moderate, none worsened, 2 resolved, and no new adverse events occurred.ConclusionsResults at 3 years after unilateral tcMRgFUS thalamotomy for ET show continued benefit, and no progressive or delayed complications. Patients may experience mild degradation in some treatment metrics by 3 years, though improvement from baseline remains significant.Clinicaltrials.gov identifierNCT01827904.Classification of evidenceThis study provides Class IV evidence that for patients with severe ET, unilateral tcMRgFUS thalamotomy provides durable benefit after 3 years.

Transdermal Nitroglycerine Enhances Spinal Neostigmine Postoperative Analgesia following Gynecological Surgery

2000 ◽  
Vol 93 (4) ◽  
pp. 943-946 ◽  
Author(s):  
Gabriela R. Lauretti ◽  
Ana-Paula M. Oliveira ◽  
Maria-do-Carmo C. Julião ◽  
Marlene P. Reis ◽  
Newton L. Pereira
Keyword(s):  
Adverse Effects ◽  
Visual Analog Scale ◽  
Postoperative Analgesia ◽  
Visual Analog Scale Score ◽  
Spinal Pain ◽  
Gynecologic Surgery ◽  
Control Group ◽  
Sensory Level ◽  
Analog Scale ◽  
American Society

Background Intrathecal neostigmine causes analgesia by inhibiting the breakdown of acetylcholine. Experimental data suggest that the production of endogenous nitric oxide is necessary for tonic cholinergic inhibition of spinal pain transmission. The purpose of this study was to determine whether association of transdermal nitroglycerine would enhance analgesia from a low dose of intrathecal neostigmine in patients undergoing gynecologic surgery during spinal anesthesia. Methods Forty-eight patients were randomized to one of four groups. Patients were premedicated with use of 0.05-0.1 mg/kg intravenous midazolam and received 15 mg bupivacaine plus 1 ml test drug intrathecally (saline or neostigmine, 5 microgram). Twenty to 30 min after the spinal puncture, a transdermal patch of either 5 mg nitroglycerin or placebo was applied. The control (Con) group received spinal saline and transdermal placebo. The neostigmine group received spinal neostigmine and transdermal placebo. The nitroglycerin group received spinal saline and a transdermal nitroglycerine patch. Finally, the neostigmine-nitroglycerin group received spinal neostigmine and transdermal nitroglycerine. Pain and adverse effects were evaluated using a 10-cm visual analog scale. Results Patients in the groups were similar regarding age, weight, height, and American Society of Anesthesiologists status. Sensory level to pin prick at 10 min, surgical duration, anesthetic duration, and visual analog scale score for pain at the time of administration of first rescue medication were statistically the same for all groups. The time to administration of first rescue analgesic (min) was longer in the neostigmine-nitroglycerin group (550 min; range, 458-1,440 min; median, 25-75th percentile) compared with the other groups (P &lt; 0.001). The neostigmine-nitroglycerin group required fewer rescue analgesics in 24 h than did the control group (P &lt; 0.0005), whereas the neostigmine group required less analgesics compared with the control group (P &lt; 0.02). The incidence of perioperative adverse effects (nausea, vomiting, headache, back pain) was similar among groups (P &gt; 0.05). Conclusion Although neither intrathecal 5 microgram neostigmine alone nor transdermal nitroglycerine alone (5 mg/day) delayed the time to administration of first rescue analgesics, the combination of both provided an average of 14 h of effective postoperative analgesia after vaginoplasty, suggesting that transdermal nitroglycerin and the central cholinergic agent neostigmine may enhance each other's antinociceptive effects at the dose studied.

scholarly journals Awake Fiberoptic or Awake Video Laryngoscopic Tracheal Intubation in Patients with Anticipated Difficult Airway Management

2012 ◽  
Vol 116 (6) ◽  
pp. 1210-1216 ◽  
Author(s):  
Charlotte V. Rosenstock ◽  
Bente Thøgersen ◽  
Arash Afshari ◽  
Anne-Lise Christensen ◽  
Claus Eriksen ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Scale Score ◽  
Visual Analog Scale ◽  
Difficult Intubation ◽  
Visual Analog Scale Score ◽  
Difficult Tracheal Intubation ◽  
Fiberoptic Intubation ◽  
Analog Scale ◽  
Intubation Success

Background Awake flexible fiberoptic intubation (FFI) is the gold standard for management of anticipated difficult tracheal intubation. The purpose of this study was to compare awake FFI to awake McGrath® video laryngoscope, (MVL), (Aircraft Medical, Edinburgh, Scotland, United Kingdom) intubation in patients with an anticipated difficult intubation. The authors examined the hypothesis that MVL intubation would be faster than FFI. Methods Ninety-three adult patients with anticipated difficult intubation were randomly allocated to awake FFI or awake MVL, patients were given glycopyrrolate, nasal oxygen, topical lidocaine orally, and a transtracheal injection of 100 mg lidocaine. Remifentanil infusion was administered intravenously to a Ramsay sedation score of 2-4. Time to tracheal intubation was recorded by independent assessors. The authors also recorded intubation success on the first attempt, investigators' evaluation of ease of the technique, and patients reported intubation-discomfort evaluated on a visual analog scale. Results Eighty-four patients were eligible for analysis. Time to tracheal intubation was median [interquartile range, IQR] 80 s [IQR 58-117] with FFI and 62 s [IQR 55-109] with MVL (P = 0.17). Intubation success on the first attempt was 79% versus 71% for FFI and MVL, respectively. The median visual analog scale score for ease of intubation was 2 (IQR 1-4) versus 1 (IQR 1-6) for FFI and MVL, respectively. The median visual analog scale score for patients' assessment of discomfort for both techniques was 2, FFI (IQR 0-3), MVL (IQR 0-4). Conclusions The authors found no difference in time to tracheal intubation between awake FFI and awake MVL intubation performed by experienced anesthesiologists in patients with anticipated difficult airway.

Flexor Tendon Sheath as a Source of Pain in Lesser Metatarsal Overload

2009 ◽  
Vol 99 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Hugo R. Perez ◽  
Joshua Roberts
Keyword(s):  
Scale Score ◽  
Visual Analog Scale ◽  
Flexor Tendon ◽  
Metatarsophalangeal Joint ◽  
Visual Analog Scale Score ◽  
Tendon Sheath ◽  
Pain Scale ◽  
Analog Scale ◽  
Scale Scores ◽  
Flexor Tendon Sheath

Background: Lesser metatarsal overload may lead to pathologic conditions ranging from plantar metatarsophalangeal joint pain to dislocation. The flexor tendon sheath lies directly plantar to the joint. The increased pressure associated with lesser metatarsal overload may lead to synovitis and pain of the flexor tendon sheath. Methods: Fifteen consecutive patients with lesser metatarsal overload had visual analog scale scores determined at three metatarsophalangeal joint areas to determine the source of pain. The patients underwent seven maneuvers to determine the pain scale score: single-leg heel raise and palpation of the second and third metatarsophalangeal joints on the plantar proximal, plantar distal, and dorsal aspects. The patients were then injected with 0.5 mL of lidocaine, 2%, into the second and third flexor tendon sheaths, and the maneuvers were repeated. Results: Before the injection, the second metatarsophalangeal joint had a significantly greater visual analog scale score plantar than dorsal (6.9 and 2.6, P ≤ .01). The flexor tendon sheath injection significantly improved all seven pain scale scores. Conclusions: Patients with lesser metatarsal overload experienced significantly greater visual analog scale pain scores on the plantar than the dorsal aspect of the second metatarsophalangeal joint. The scores significantly improved after diagnostic injection in the flexor tendon sheaths. The flexor tendon sheaths are probably involved in patients with primarily plantar pain. (J Am Podiatr Med Assoc 99(2): 129–134, 2009)

scholarly journals The role of intercostal nerve preservation in acute pain control after thoracotomy

2014 ◽  
Vol 40 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Marco Aurélio Marchetti-Filho ◽  
Luiz Eduardo Villaça Leão ◽  
Altair da Silva Costa-Junior
Keyword(s):  
Pain Intensity ◽  
Visual Analog Scale ◽  
Acute Pain ◽  
Visual Analog Scale Score ◽  
Intercostal Nerve ◽  
Sao Paulo ◽  
Neurovascular Bundle ◽  
São Paulo ◽  
Analog Scale ◽  
Nerve Preservation

OBJECTIVE: To evaluate whether the acute pain experienced during in-hospital recovery from thoracotomy can be effectively reduced by the use of intraoperative measures (dissection of the neurovascular bundle prior to the positioning of the Finochietto retractor and preservation of the intercostal nerve during closure). METHODS: We selected 40 patients who were candidates for elective thoracotomy in the Thoracic Surgery Department of the Federal University of São Paulo/Paulista School of Medicine, in the city of São Paulo, Brazil. The patients were randomized into two groups: conventional thoracotomy (CT, n = 20) and neurovascular bundle preservation (NBP, n = 20). All of the patients underwent thoracic epidural anesthesia and muscle-sparing thoracotomy. Pain intensity was assessed with a visual analog scale on postoperative days 1, 3, and 5, as well as by monitoring patient requests for/consumption of analgesics. RESULTS: On postoperative day 5, the self-reported pain intensity was significantly lower in the NBP group than in the CT group (visual analog scale score, 1.50 vs. 3.29; p = 0.04). No significant differences were found between the groups regarding the number of requests for/consumption of analgesics. CONCLUSIONS: In patients undergoing thoracotomy, protecting the neurovascular bundle prior to positioning the retractor and preserving the intercostal nerve during closure can minimize pain during in-hospital recovery.

scholarly journals Local Efficacy of Corticosteroids as an Adjuvant for Periarticular Cocktail Injection in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective Randomized Double-blind Controlled Trial

2020 ◽  
Author(s):  
huiming peng ◽  
wei wang ◽  
jin lin ◽  
xisheng weng ◽  
wenwei qian ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Visual Analog Scale ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Visual Analog Scale Score ◽  
Analog Scale ◽  
Double Blind ◽  
Total Knee ◽  
Double Blinded ◽  
Hss Score

Abstract Background: Multimodal cocktail periarticular injection(MCPI) including corticosteroids is currently widely applied to reduce postoperative pain and swelling following total knee arthroplasty (TKA). However the addition of steroids is controversial.This prospective, double-blinded, randomized, controlled trial compares the safety and efficacy of MCPI with or without corticosteroids.Methods: A total of 60 patients (120 knees) who underwent simultaneous bilateral TKAs received periarticular injections with added betamethasone (7mg) in a randomly selected knee, and the other knee was injected without added corticosteroids. The visual analog scale(VAS) pain scores at rest and in motion, range of motion (ROM), thigh swelling, hospital for special surgery(HSS) score, and adverse events were compared between the 2 knees.Results: There were no statistically significant differences in the visual analog scale score, ROM, thigh girth, HSS score, and complications between the 2 kness. The patients were unable to detect a difference in the functional recovery between their knees on postoperative day 3or at the 3 month follow-up.Conclusion: Betamethasone injections are ineffective locally for relieving pain, reducing swelling, and improving the postoperative ROM.Trial registration: Chinese Clinical Trial RegistryNumber: ChiCTR-OPC-17013503, Date of Registration: 2017-11-23 URL:http://www.chictr.org.cn/showproj.aspx?proj=23146

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