scholarly journals Conservative Treatment for Primary Metatarsalgia

2021 ◽  
Vol 2 (1) ◽  
pp. 22-25
Author(s):  
Kentaro Amaha
Keyword(s):  
Surgical Treatment ◽  
Pressure Reduction ◽  
Front Part ◽  
Forefoot Pain ◽  
Metatarsal Bones ◽  
Plantar Aspect ◽  
Common Causes ◽  
Inflammatory Drugs ◽  
Treatment Pressure ◽  
Shoe Inserts

Metatarsalgia is one of the most common causes of forefoot pain, and it is characterized by pain in the front part of the foot under the head of the metatarsal bones. Primary metatarsalgia is idiopathic, but it has been suggested to be related to forefoot plantar compression. Because of the various causes of metatarsalgia, there is the need to thoroughly consider the etiology of metatarsalgia to find novel, effective, and conservative treatments for metatarsalgia to avoid surgical treatment. Pressure reduction or redistribution can be achieved using toe exercise, flat shoe inserts, metatarsal pads, custom-molded inserts, and rockerbars. There was no need for one treatment. If toe function was poor, toe exercises were recommended. If dorsiflexion of the ankle joint was limited, the Achilles tendon was stretched. If the pain was localized to the plantar aspect of the 2nd MTP, a decompression insole was applied. If the pain was limited to the plantar aspect of the 2nd MTP, a decompression insole was worn. If swelling occurred, anti-inflammatory drugs were indicated to reduce inflammation. The combination of the two was appropriate for this condition. Toe exercises can improve balance and are worth trying. An in-depth understanding of the various etiologies of metatarsal and toe deformities is essential for successful treatment.

scholarly journals Common Causes and Characteristics of Adverse Drug Reactions in Older Adults: A Retrospective Study

2020 ◽  
Author(s):  
Seong-Dae Woo ◽  
Jiwon Yoon ◽  
Go-Eun Doo ◽  
Youjin Park ◽  
Youngsoo Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Adverse Drug Reactions ◽  
Drug Reactions ◽  
Younger Patients ◽  
Iodinated Contrast ◽  
Common Causes ◽  
Aging Populations ◽  
Pharmacovigilance Center ◽  
Inflammatory Drugs ◽  
Rate Ratios

Abstract Background: Aging populations are often accompanied by comorbidity and polypharmacy, leading to increases in adverse drug reactions (ADRs). We sought to evaluate the causes and characteristics of ADRs in older Korean adults (≥65 years) in comparison to younger individuals (<65 years). Methods: Of 37,523 cases reported at a Korean pharmacovigilance center from 2011 to 2018, we reviewed 18,842 ADRs of certain or probable causality on the basis of WHO-UMC criteria. We estimated the number of ADRs per 1,000 patients exposed to the major culprit drugs, and incidence rate ratios were obtained to assess high- and low-risk medications in older adults. Results: In total, 4,152 (22.0%) ADRs were reported for 3,437 older adults (mean age, 74.6 years and 57.3% female). Tramadol (rate ratio, 1.32; 95% confidence interval [CI], 1.21-1.44; P <0.001) and fentanyl (1.49, 1.16-1.92, P =0.002) posed higher risks of ADRs in the older adults, whereas nonsteroidal anti-inflammatory drugs (NSAIDs) (0.35, 0.30-0.40, P <0.001) and iodinated contrast media (ICM) (0.82, 0.76-0.89, P <0.001) posed lower risks. Ratios of serious ADRs to NSAIDs (odds ratio, 2.16; 95% CI, 1.48-3.15; P <0.001) and ICM (2.09, 1.36-3.21, P= 0.001) were higher in the older adults than in the younger patients. Analgesics primarily elicited cutaneous ADRs in the younger patients and gastrointestinal reactions in the older adults. ICM more commonly led to anaphylaxis in the older adults than the younger patients (3.0% vs. 1.6%, P =0.019). Conclusion: For early detection of ADRs in older adults, better understanding of differences in the causes and characteristics thereof in comparison to the general population is needed.

Anaphylaxis

2010 ◽  
pp. 3106-3114 ◽  
Author(s):  
Anthony F.T. Brown
Keyword(s):  
Mast Cell ◽  
Smooth Muscle Contraction ◽  
Lipid Mediators ◽  
Feedback Mechanisms ◽  
Radiocontrast Media ◽  
Cytokines And Chemokines ◽  
Immune Mediated ◽  
Common Causes ◽  
Inflammatory Drugs ◽  
Cytokine Cascade

The term anaphylaxis describes both IgE immune-mediated reactions and nonallergic, nonimmunologically triggered events. Comorbidities such as asthma or infection, exercise, alcohol, or stress and concurrent medications such as β‎-blockers and aspirin increase the risk known as ‘summation anaphylaxis’. Aetiology and pathogenesis—activated mast cells and basophils release preformed, granule-associated mediators and newly formed lipid mediators, and generate cytokines and chemokines. These cause vasodilatation, increased capillary permeability, and smooth muscle contraction, as well as attract new cells to the area. Positive feedback mechanisms amplify the reaction in a ‘mast cell—leucocyte cytokine cascade’, although conversely reactions can be self-limiting. Parenteral penicillins, hymenopteran stings, and food are the most common causes of IgE immune-mediated fatalities, with radiocontrast media, aspirin, and other nonsteroidal anti-inflammatory drugs most commonly responsible for nonallergic fatalities....

Anaphylaxis

2020 ◽  
pp. 3849-3859
Author(s):  
Anthony F.T. Brown
Keyword(s):  
Mast Cell ◽  
Immunoglobulin E ◽  
Smooth Muscle Contraction ◽  
Lipid Mediators ◽  
Radiocontrast Media ◽  
Cytokines And Chemokines ◽  
Immune Mediated ◽  
Common Causes ◽  
Inflammatory Drugs ◽  
Cytokine Cascade

The term anaphylaxis describes both immunoglobulin E (IgE) immune-mediated reactions, plus non-IgE immune-mediated, and non-allergic, non-immunologically triggered events. Comorbidities such as asthma or infection, exercise, alcohol, or stress and concurrent medications such as β‎-blockers and aspirin increase the risk, a concept known as ‘summation anaphylaxis’. Activated mast cells and basophils release preformed, granule-associated mediators and newly formed lipid mediators, and generate cytokines and chemokines. These cause vasodilatation, increased capillary permeability, and smooth muscle contraction, as well as attracting new cells to the area. Positive feedback enhancing mechanisms amplify the reaction in a ‘mast cell—leucocyte cytokine cascade’, although conversely reactions can be self-limiting. Parenteral penicillins, hymenopteran stings, and food are the most common causes of IgE immune-mediated fatalities, with radiocontrast media, aspirin, and other non-steroidal anti-inflammatory drugs most commonly responsible for non-IgE and non-allergic fatalities.

scholarly journals The Primary Metatarsalgia: Pathogenesis, Biomechanics and Surgical Treatment

2017 ◽  
Vol 72 (1) ◽  
pp. 53-58
Author(s):  
D. S. Bobrov ◽  
L. J. Slinjakov ◽  
N. V. Rigin
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Supporting Surface ◽  
Excessive Pressure ◽  
Functional Changes ◽  
Treatment Techniques ◽  
Tendon Lengthening ◽  
Metatarsal Bones ◽  
Wide Range ◽  
The One

This paper presents a comprehensive review on the current concept of the diagnosis and treatment of central metatarsalgia on the basis of medical literature analyses. Metatarsalgia is the term for pain in the forefoot. This is a set of symptoms corresponding to a wide range of diseases. Central metatarsalgia is a kind of metatarsalgia which arises from structural-functional changes that lead to excessive pressure in the area of metatarsal heads. The data analysis demonstrated that presently various types of osteotomies of metatarsal bones are the main surgical treatment options with the chance of complication ranging from 6 to 50%. Weil-osteotomy is known to be the most popular type of osteotomy for treatment of central metatarsalgia. The most common complication of Weil-osteotomy is floating toe, the one that doesn’t contact with the supporting surface. In case Weil-osteotomy and intraphalangeal arthrodesis with trans acticular fixation are both performed, the complication of floating toe increases up to 50%. When Weil osteotomy, plantar plate repair, extensor digitorum longum tendon lengthening and triple Weil-osteotomy are performed simultaneously, the complication rate is 15% approximately which is much lower. Using combined osteotomy techniques as well as taking into account structural-functional pathologic changes of the forefoot and ligaments repair of metatarsalphalangeal joint will ensure the most successful development of surgical treatment techniques for central metatarsalgia.

scholarly journals Paediatric flatfoot

2020 ◽  
Vol 16 (4) ◽  
pp. 368-372
Author(s):  
Ryszard Tomaszewski ◽  
◽  
Barbara Czasławska ◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Conservative Treatment ◽  
Radiological Evaluation ◽  
Foot Deformity ◽  
Flat Foot ◽  
Small Children ◽  
Flat Feet ◽  
Inflammatory Drugs ◽  
Therapeutic Problem

Paediatric flat feet are a serious therapeutic problem. During the child’s development, the foot is subject to the processes of anatomical and physiological modifications. In small children, the flat foot is a physiological variant. The assessment of the flat foot deformity is based on clinical examination, a podoscope examination and possibly radiological evaluation. Only from the age of about 3 years is it possible to consider the implementation of treatment, initially conservative with rehabilitation and possibly orthotics. Some patients require treatment with analgesics, anti-inflammatory drugs or physiotherapy due to the pain they experience, especially in the hindfoot. The lack of progress in conservative treatment requires consideration of surgical treatment, which must be individually adjusted. Arthroereisis, possibly combined with the elongation of the Achilles tendon, is the most commonly used treatment. In fixed deformities or congenital flat feet, corrective bone procedures are also performed, usually combined with soft tissue procedures.

scholarly journals Surgical Treatment of Biliary Strictures after Liver Transplantation: A Single Center Experiences

2020 ◽  
Vol 3 (3) ◽  
pp. 69-74
Author(s):  
Ertugrul Gokhan ◽  
◽  
Yanaral Tumay ◽  
Keyword(s):  
Liver Transplantation ◽  
Surgical Treatment ◽  
Postoperative Morbidity ◽  
Biliary Stricture ◽  
Biliary Strictures ◽  
Donor Liver Transplantation ◽  
Common Causes ◽  
End Stage ◽  
Transhepatic Biliary Drainage

Aim: Liver transplantation is the only treatment for end-stage liver disease. Biliary tract pathologies that develop after liver transplantation are the most common causes of morbidity. The aim of this retrospective study was to evaluate the outcomes of surgical treatment for biliary strictures. Patients and Methods: In this study, only surgical treatment applied biliary strictures were evaluated. Between April 2014 and April 2018 at Medipol University Medical Faculty Hospital Organ Transplantation Department, Istanbul, Turkey, 129 patients with living donor liver transplantation were studied retrospectively. Results: Seven patients (5.4%) were done surgical treatment, because all percutaneous transhepatic biliary drainage (PTBD) has failed. In these patients, no exhibited postoperative morbidity, mortality and recurrence of biliary strictures in follow up 35 months. Conclusions: Surgical treatment appears to be successful in when PTBD have failed biliary stricture patients, after liver transplantation.

scholarly journals Medikamentozno zdravljenje endometrioze: pregled stanja in nove možnosti zdravljenja

2016 ◽  
Vol 85 (7-8) ◽  
Author(s):  
Maja Jakič ◽  
Andrej Vogler ◽  
Tea Lanišnik Rižner
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Uterine Cavity ◽  
Pharmacological Treatments ◽  
Gynecological Examination ◽  
Combination Studies ◽  
Hormonal System ◽  
Gynecological Disease ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Endometriosis is a gynecological disease that is defined as the presence of endometrium-like tissue outside the uterine cavity, and it is one of the main causes of female infertility. Although there is unfortunately no known ‘optimal’ treatment for endometriosis, there are three treatment options: medication, surgical treatment, and a combination of both. The gold standard for diagnosis of endometriosis is a diagnostic laparoscopy, which is also therapeutic. Indications for pharmacological treatment of endometriosis include empirical treatment for patients with pelvic pain who are normal on gynecological examination, or who have recurrent disease after surgical treatment or in combination with surgical treatment. In everyday practice, non-steroid anti-inflammatory drugs, oral contraceptives, and progestins per os are used as first-line pharmacological treatments of endometriosis. Gonadoliberin agonists can be used as second-line treatment, although their use is discouraged. These medications can be used alone or in combination. Studies over the last 10 years have shown that many other agents have potential for treatment of endometriosis. These can be broadly classified into several groups: anti-inflammatory agents, and agents that interfere with the hormonal system, or with other pathophysiological processes, such as a disturbed immune system, reduced apoptosis, enhanced angiogenesis, degradation of the extracellular matrix, increased oxidative stress, and epigenetic changes. However, their introduction into routine use requires more convincing clinical studies to confirm their effectiveness.

scholarly journals Combined iridencleisis and posterior sclerectomy in surgical treatment of glaucoma secondary to uveitis in a dog: a case report

2009 ◽  
Vol 54 (No. 3) ◽  
pp. 142-148
Author(s):  
M. Lew ◽  
S. Lew
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Positive Result ◽  
Anterior Uveitis ◽  
Aqueous Humour ◽  
Secondary Glaucoma ◽  
Constant Level ◽  
Subconjunctival Space ◽  
Common Causes ◽  
Posterior Synechiae

In early diagnosed and causally treated cases of secondary glaucoma, it is possible to save the sight in a glaucomatous eye and to preserve the sight in a healthy eye. The most common causes of secondary glaucoma include anterior uveitis, in which diverse pathological processes can lead to an increase in IOP. In cases of treating glaucoma secondary to uveitis with annular posterior synechiae in connection with peripheral anterior synechiae, iridencleisis is the method of choice. This article presents the results of the eight-month treatment of such a case with iridencleisis combined with posterior sclerectomy. This method makes it possible to increase the area of aqueous humour outflow to the subconjunctival space. The treatment resulted in the reduction of IOP in the left eye from the preoperative value of 72 mmHg to 15 mmHg, which was maintained at a constant level during the eight-month period following the surgery. Sight assessment in the operated eye, carried out on the basis of PLR, menace and dazzle response, brought a moderately positive result.

Surgical Emergencies from Adnexal Masses

2018 ◽  
Vol 15 (1) ◽  
pp. 50-56
Author(s):  
Amanda M. Jackson ◽  
Kristen P. Zeligs
Keyword(s):  
Emergency Department ◽  
Surgical Treatment ◽  
Ectopic Pregnancy ◽  
Review Article ◽  
Clinical Context ◽  
Surgical Exploration ◽  
Adnexal Masses ◽  
Surgical Emergencies ◽  
Common Causes ◽  
Ovarian Abscess

Adnexal masses are commonly found on imaging of patients presenting to the emergency department with pelvic pain. Depending on the clinical context, emergent surgical exploration may be warranted. In this review article, we discuss the most common causes of adnexal masses requiring emergent surgical treatment, to include ectopic pregnancy, ovarian torsion, ruptured hemorrhagic cyst, and tubo-ovarian abscess.

Role of Panchakarma intervention in Amlapitta (Gastritis): A Critical Review

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Kaushal Kumar Sinha ◽  
Sahu Lalravi ◽  
S. Shruthi ◽  
B. A. Lohith ◽  
Imli Kumba
Keyword(s):  
Medical Science ◽  
Signs And Symptoms ◽  
The Body ◽  
Common Disease ◽  
Essential Components ◽  
Common Causes ◽  
Purification Methods ◽  
Inflammatory Drugs ◽  
H Pylori

Amlapiita is a very common disease of present era and a disease of Annavaha Strotas, and is commonly observed in these days of modernization and industrialization. 30% of the general population is suffering from gastro-oesophageal reflux and gastritis resulting in heartburn. It is very troublesome disease and can give rise to many serious problems if not treated in time. Signs and symptoms of Amlapiita are very similar to gastritis or hyperacidity. According to conventional medical science the most common causes of gastritis are H. pylori infections and prolonged use of Non-Steroidal Anti Inflammatory Drugs (NSAIDS). Gastritis is believed to affect about half of people worldwide. In 2015 there were approximately 90 million new cases of this condition. As people get older the disease becomes more common. It, along with a similar condition in the first part of the intestines known as duodenitis, resulted in 50,000 deaths in 2017. The five procedure of Panchakarma done through several procedures purify the body system by removing morbid Doshas from the body. These purification methods are essential components of the curative management of these diseases that are not controlled by palliative management.

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