• 제목/요약/키워드: Inflammatory pain

검색결과 767건 처리시간 0.024초

Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

  • Manjushri, Waingade;Raghavendra S, Medikeri;Shamali, Gaikwad
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권6호
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    • pp.405-417
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    • 2022
  • Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have been proposed for its management as alternative to corticosteroids. However, no definitive treatment has been identified that can result in complete remission or minimal recurrence. Hyaluronic acid has recently been used as an alternative therapy for the management of OLP. This study aimed to systematically review the effectiveness of Hyaluronic acid in the management of symptomatic OLP. Online electronic databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and April 2022. RCTs were identified that compared the efficacy of hyaluronic acid and other interventional therapies at baseline and during follow-up. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, degree of erythema, clinical severity, and disease severity were assessed both quantitatively and qualitatively. Seven studies were analyzed. Five studies reported a high risk of bias while the remaining two studies reported an unclear risk of bias. The overall quantitative assessment of size, symptoms, degree of erythema, and sign score in OLP lesions treated with HA was not statistically significant compared to that in the control group (P > 0.05). In addition, subgroup analysis comparing HA with placebo or corticosteroids did not yield statistically significant (P > 0.05) results. Qualitatively, both HA and tacrolimus resulted in an effective reduction in signs and symptoms. Clinical/disease severity index/scores were inconsistent. A high degree of heterogeneity was observed among the included studies. None of the included studies reported the side effects of HA. These findings suggest that corticosteroids, tacrolimus, placebo, and HA could be equally effective in OLP management. The clinical/disease severity index or score reduction cannot be determined with certainty. Thus, OLP can be treated with HA as an alternative therapy. Owing to limited clinical trials on HA, high heterogeneity, and high risk of bias in the included studies, definitive conclusions cannot be derived.

Nonoperative management of colon and mesocolon injuries caused by blunt trauma: three case reports

  • Naa, Lee;Euisung, Jeong;Hyunseok, Jang;Yunchul, Park;Younggoun, Jo;Jungchul, Kim
    • Journal of Trauma and Injury
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    • 제35권4호
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    • pp.291-296
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    • 2022
  • The therapeutic approach for colon injury has changed continuously with the evolution of management strategies for trauma patients. In general, immediate laparotomy can be considered in hemodynamically unstable patients with positive findings on extended focused assessment with sonography for trauma. However, in the case of hemodynamically stable patients, an additional evaluation like computed tomography (CT) is required. Surgical treatment is often required if prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation are observed. However, immediate intervention in hemodynamically stable patients without indications for surgical treatment remains questionable. Three patients with colon and mesocolon injuries caused by blunt trauma were treated by nonoperative management. At the time of admission, they were alert and their vital signs were stable. Colon and mesocolon injuries, large hematoma, colon wall edema, and/or ischemia were revealed on CT. However, no prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation were observed. In two cases, conservative treatment was performed without worsening abdominal pain or laboratory tests. Follow-up CT showed improvement without additional treatment. In the third case, follow-up CT and percutaneous drainage were performed in considering the persistent left abdominal discomfort, fever, and elevated inflammatory markers of the patient. After that, outpatient CT showed improvement of the hematoma. In conclusion, nonoperative management can be considered as a therapeutic option for mesocolon and colon injuries caused by blunt trauma of selected cases, despite the presence of large hematoma and ischemia, if there are no clear indications for immediate intervention.

Constant score in asymptomatic shoulders varies with different demographic populations: derivation of adjusted score equation

  • Nitesh Gahlot;Ankit Rai;Jeshwanth Netaji
    • Clinics in Shoulder and Elbow
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    • 제25권4호
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    • pp.274-281
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    • 2022
  • Background: In the present study, the age- and sex-adjusted Constant score (CS) in a normal Indian population was calculated and any differences with other population cohorts assessed. Methods: The study participants were patients who visited the outpatient department for problems other than shoulder and healthy volunteers from the local population. Patients without shoulder pain/discomfort during activity were included in the study. Subjects with any problem that might affect shoulder function (e.g., cervical, thoracic spine, rib cage deformity, inflammatory arthritis) were excluded. Constant scoring of all participants was performed by trained senior residents under the supervision of the senior faculty. Shoulder range of movement and strength were measured following recommendations given by the research and Development Committee of the European Society for Shoulder and Elbow Surgery (2008). A fixed spring balance was used for strength measurement; one end was fixed on the floor and the other end tied with a strap to the wrist of the participant, arm in 90° abduction in scapular plane with palm facing down. Results: Among the 248 subjects (496 shoulders), the average age was 37 years (range, 18-78 years), 65.7% were males (326 shoulders) and 34.3% females (170 shoulders). The mean CS was 84.6±2.9 (males, 86.1±3.0; females, 81.8±2.9). CS decreased significantly after 50 years of age in males and 40 years of age in females (p<0.05). The mean CS was lower than in previous studies for both males and females. Heavy occupation workers had higher mean CS (p<0.05). A linear standardized equation was estimated for calculating the adjusted CS for any age. Conclusions: Mean CS and its change with age differed from previous studies among various population cohorts.

Kikuchi-Fujimoto Disease Mimicking Mesenteric Lymphadenitis in Children: A Case Report and Systematic Review

  • Gyeongseo Jeon;Si-Hwa Gwag;Young June Choe;Saelin Oh;Jun Eun Park
    • Pediatric Infection and Vaccine
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    • 제30권1호
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    • pp.39-46
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    • 2023
  • 기쿠치-후지모토병(Kikuchi-Fujimoto disease, KFD)은 주로 소아 및 젊은 성인에서 발생하는 급성 발열성 질환이며, 주로 조직구증성 괴사성 림프선염을 특징으로 한다. KFD는 조직검사를 통한 병리학적 검증이 어려울 경우 진단이 제한적일 수 있다. 본 논문에서는 복통과 복강내 림프선염 등으로 진단이 늦어졌던 11세 남아의 사례를 보고한다. 추가로 체계적인 문헌고찰을 수행하였으며, KFD 질병의 범위, 치료 및 예후를 기술하고자 하였다. 본 체계적 문헌고찰에서는 미국, 유럽 및 아시아에서 출간된 장관막 림프선염과 유사한 증상을 보이는 KFD 증례 15건을 분석하였다. 대부분의 환자는 남성이었으며, 백혈구 감소증(leukopenia)과 염증 표지자 상승이 나타났으며, 대부분 중대한 후유증이나 합병증 없이 회복되었다. 복강내 림프선염을 동반한 발열을 주소로 내원하는 소아에 대해서 KFD 가능성을 검토하는 것이 필요할 수 있다.

성숙한 당나귀의 큰잘록창자 폐색 증례 (A Case of the Large Colon Impaction in an Adult Donkey)

  • 양재혁;박용수
    • 현장농수산연구지
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    • 제20권2호
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    • pp.117-123
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    • 2018
  • 본 연구의 목적은 성숙한 당나귀의 큰잘록 창자 폐색 증례를 진단하여 보고하고자 한다. 당나귀(Equus africanus asinus; 암, 6세) 1마리가 제주경마공원 동물병원에 전날부터 시작된 식욕부진 증상으로 내원하였다. 장음소실, 탈수, 심한 복강 확장 등의 증상을 확인하였으나 호흡수 및 심박수는 정상이었고, 복통 증상은 없었다. 직장검사에서 폐색된 부분이 잘록 창자임을 확인하였다. 위세척, 수액요법 및 비스테로이드 계열의 진통제를 투여하였으나 다음날 새벽 갑자기 몸을 떨며 기립곤란과 같이 신체상태가 악화되기 시작한지 2시간 만에 폐사하였다. 부검에서 특히 왼배쪽 잘록 창자와 같은 큰잘록 창자에서 다량의 식괴를 발견하였고, 막창자와 곧창자는 정상이었다. 당나귀는 내원하기 11일 전에 새로 입사해서 사양 관리체계가 바뀌었다. 사료변경, 수분섭취 감소, 운동부족 등이 질병을 유발하였을 것으로 생각된다. 그러나 당나귀의 정확한 급사원인은 더 연구해야 할 과제로 남는다.

Effect of cryotherapy duration on experimentally induced connective tissue inflammation in vivo

  • Jorge Vera;Mayra Alejandra Castro-Nunez;Maria Fernanda Troncoso-Cibrian;Ana Gabriela Carrillo-Varguez;Edgar Ramiro Mendez Sanchez;Viviana Sarmiento;Lourdes Lanzagorta-Rebollo;Prasanna Neelakantan;Monica Romero;Ana Arias
    • Restorative Dentistry and Endodontics
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    • 제48권3호
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    • pp.29.1-29.8
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    • 2023
  • Objectives: This study tested the hypothesis that cryotherapy duration influences lipopolysaccharide (LPS)-induced inflammation in a rat model. Materials and Methods: Six Wistar rats (Rattus norvegicus albinus) were used. Five sites were selected per animal and divided into 5 groups: a negative control group (NC), 2 positive control groups (PC1 and PC2), and 2 experimental groups (E1 and E2). Cryotherapy was applied for 1 minute (E1) or 5 minutes (E2). An acute inflammatory response was induced in the PC and E groups via subcutaneous administration of 0.5 mL/kg. In the PC2 group, a catheter was inserted without additional treatment. For the E1 and E2 groups, 2.5℃ saline solution was administered through the implanted catheters for 1 and 5 minutes, respectively. The rats were sacrificed, and samples were obtained and processed for histological analysis, specifically examining the presence of polymorphonuclear neutrophils and hemorrhage. The χ2 test was used to compare the presence of acute inflammation across groups. Dependent variables were compared using the linear-by-linear association test. Results: Inflammation and hemorrhage varied significantly among the groups (p = 0.001). A significantly higher degree of acute inflammation was detected (p = 0.0002) in the PC and E1 samples than in the E2 group, in which cryotherapy was administered for 5 minutes. The PC and E1 groups also exhibited significantly greater numbers of neutrophils (p = 0.007), which were essentially absent in both the NC and E2 groups. Conclusions: Cryotherapy administration for 5 minutes reduced the acute inflammation associated with LPS and catheter implantation.

바이러스성 위장염에 효과를 가지는 프로바이오틱스: 총설 (Anti-Viral Activities of Probiotics against Viral Gastroenteritis: A Review)

  • 천정환;윤혜영;김현진;오형석;강석형;황원욱;정하정;김현주;서건호;송광영
    • Journal of Dairy Science and Biotechnology
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    • 제41권3호
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    • pp.87-102
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    • 2023
  • Globally, acute gastroenteritis is responsible for two million pediatric deaths. In particular, viral gastroenteritis is the most common cause of acute diarrhea, and most children aged <5 years are infected at least once. The common symptoms include profuse watery diarrhea, vomiting, abdominal pain, and fever. Viral gastroenteritis is generally caused by rotavirus, norovirus, astrovirus, and adenovirus. Recently, probiotics use has increased rapidly worldwide due to its inhibitory effect against viral gastroenteritis. In addition, probiotics are known to have anti-inflammatory and anti-allergic effects and enhance immunity without any side effects. Therefore, this review focuses on the anti-viral effects of probiotics on viral gastroenteritis. Furthermore, this review would provide basic data that could be used for developing new products that have improved functionality by addition of probiotics to milk and dairy food.

Perioperative management of facial reconstruction surgery in patients with end-stage renal disease undergoing dialysis

  • Chan Woo Jung;Yong Chan Bae
    • 대한두개안면성형외과학회지
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    • 제25권2호
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    • pp.71-76
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    • 2024
  • Background: The rising incidence of dialysis-dependent end-stage renal disease (ESRD) has underscored the need for collaboration between plastic surgeons and nephrologists, particularly concerning preoperative and postoperative management for facial reconstruction. This collaboration is essential due to a scarcity of comprehensive information in this domain. Methods: A study initiated in January 2015 involved 10 ESRD cases on dialysis undergoing Mohs micrographic surgery for facial skin cancer, followed by reconstructive surgery under general anesthesia. To ensure surgical safety, rigorous measures were enacted, encompassing laboratory testing, nephrology consultations, and preoperative dialysis admission. Throughout surgery, meticulous control was exercised over vital signs, electrolytes, bleeding risk, and pain management (excluding nonsteroidal anti-inflammatory drugs). Postoperative assessments included monitoring flap integrity, hematoma formation, infection, and cardiovascular risk through plasma creatinine levels. Results: Adherence to the proposed guidelines yielded a notable absence of postoperative wound complications. Postoperative plasma creatinine levels exhibited an average decrease of 1.10 mg/dL compared to preoperative levels, indicating improved renal function. Importantly, no cardiopulmonary complications or 30-day mortality were observed. In ESRD patients, creatinine levels decreased significantly postoperatively compared to the preoperative levels (p< 0.05), indicating favorable outcomes. Conclusion: The consistent application of guidelines for admission, anesthesia, and surgery yielded robust and stable outcomes across all patients. In particular, the findings support the importance of adjusting dialysis schedules. Despite the limited sample size in this study, these findings underscore the effectiveness of a collaborative and meticulous approach for plastic surgeons performing surgery on dialysis-dependent patients, ensuring successful outcomes.

Guillain-Barré syndrome associated with SARS-CoV-2 vaccination: how is it different? a systematic review and individual participant data meta-analysis

  • Yerasu Muralidhar Reddy;Jagarlapudi MK Murthy;Syed Osman;Shyam Kumar Jaiswal;Abhinay Kumar Gattu;Lalitha Pidaparthi;Santosh Kumar Boorgu;Roshan Chavan;Bharadwaj Ramakrishnan;Sreekanth Reddy Yeduguri
    • Clinical and Experimental Vaccine Research
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    • 제12권2호
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    • pp.143-155
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    • 2023
  • Purpose: An association between Guillain-Barré syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination has been reported. We aimed to summarize the clinical features of GBS associated with SARS-CoV-2 vaccination and determine the contrasting features from coronavirus disease-19 (COVID-19) associated GBS and GBS following other causes. Materials and Methods: We performed PubMed search for articles published between 1 December 2020 and 27 January 2022 using search terms related to "SARS-CoV-2 vaccination" and "GBS". Reference searching of the eligible studies was performed. Sociodemographic and vaccination data, clinical and laboratory features, and outcomes were extracted. We compared these findings with post-COVID-19 GBS and International GBS Outcome Study (IGOS) (GBS from other causes) cohorts. Results: We included 100 patients in the analysis. Mean age was 56.88 years, and 53% were males. Six-eight received non-replicating virus vector and 30 took messenger RNA (mRNA) vaccines. The median interval between the vaccination and the GBS onset was 11 days. Limb weakness, facial palsy, sensory symptoms, dysautonomia, and respiratory insufficiency were seen in 78.65%, 53.3%, 77.4%, 23.5%, and 25%, respectively. The commonest clinical and electrodiagnostic subtype were sensory-motor variant (68%) and acute inflammatory demyelinating polyneuropathy (61.4%), respectively. And 43.9% had poor outcome (GBS outcome score ≥3). Pain was common with virus vector than mRNA vaccine, and the latter had severe disease at presentation (Hughes grade ≥3). Sensory phenomenon and facial weakness were common in vaccination cohort than post-COVID-19 and IGOS. Conclusion: There are distinct differences between GBS associated with SARS-CoV-2 vaccination and GBS due to other causes. Facial weakness and sensory symptoms were commonly seen in the former and outcomes poor.

Mitochondrial Transplantation Ameliorates the Development and Progression of Osteoarthritis

  • A Ram Lee;Jin Seok Woo;Seon-Yeong Lee;Hyun Sik Na;Keun-Hyung Cho;Yeon Su Lee;Jeong Su Lee;Seon Ae Kim;Sung-Hwan Park;Seok Jung Kim;Mi-La Cho
    • IMMUNE NETWORK
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    • 제22권2호
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    • pp.14.1-14.17
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    • 2022
  • Osteoarthritis (OA) is a common degenerative joint disease characterized by breakdown of joint cartilage. Mitochondrial dysfunction of the chondrocyte is a risk factor for OA progression. We examined the therapeutic potential of mitochondrial transplantation for OA. Mitochondria were injected into the knee joint of monosodium iodoacetate-induced OA rats. Chondrocytes from OA rats or patients with OA were cultured to examine mitochondrial function in cellular pathophysiology. Pain, cartilage destruction, and bone loss were improved in mitochondrial transplanted-OA rats. The transcript levels of IL-1β, TNF-α, matrix metallopeptidase 13, and MCP-1 in cartilage were markedly decreased by mitochondrial transplantation. Mitochondrial function, as indicated by membrane potential and oxygen consumption rate, in chondrocytes from OA rats was improved by mitochondrial transplantation. Likewise, the mitochondrial function of chondrocytes from OA patients was improved by coculture with mitochondria. Furthermore, inflammatory cell death was significantly decreased by coculture with mitochondria. Mitochondrial transplantation ameliorated OA progression, which is caused by mitochondrial dysfunction. These results suggest the therapeutic potential of mitochondrial transplantation for OA.