A novel “Enhanced Recovery After Surgery” (ERAS) protocol developed by Penn Medicine for patients undergoing spinal and peripheral nerve surgery significantly reduced opioid use. A new study published in the Journal of Neurosurgery: Spine showed that when an ERAS protocol was employed—which optimizes patients’ surgical care before, during, and after surgery, including patient education, post-operative medications, and recovery plans—fewer patients needed pain medications one month after surgery.
Nearly 75 percent of patients at Penn Medicine who undergo spinal surgeries are opioid naïve—patients who are not chronically taking opioids on a daily basis—putting them at an increased risk for dependency following surgery. Previous studies have also shown that up to 7 percent of all patients who undergo spinal surgeries continue to take opioids one year after surgery. Part of the ERAS protocol at Penn includes a personalized, safe, and effective pain management plan to help prevent opioid dependency, which has rapidly become a public health crisis in the United States.
In light of what it describes as a “significant public health concern,” the US Centers for Disease Control and Prevention (CDC) has issued what it says are the first-ever comprehensive clinical guidelines for the diagnosis and management of mild traumatic brain injury (mTBI) in children. The 19 sets of recommendations address the condition from diagnosis through management and treatment, and cover settings including primary care, outpatient settings, inpatient care, schools, and emergency departments.
The resource, published in JAMA Pediatrics and available for free, is organized into 3 main areas—diagnostic recommendations, prognostic recommendations, and recommendations related to management and treatment—with each area containing several recommendations based on extensive literature reviews. The 46 discrete recommendations are organized into 19 topic areas, and include do’s and don’ts that cover the gamut from the use of serum testing to diagnose mTBI to the best approaches for talking with families about the injury.
Falls are not just a problem of advanced age, according to researchers in Trinity College Dublin, who have identified a sharp increase in falls after the age of 40, particularly in women.
The research, which drew on data from TILDA (the Irish Longitudinal Study on Ageing) as well as data from similar studies in Australia, Great Britain and the Netherlands, found that for women the prevalence of falls increases from the age of 40 on — 9% in 40-44 year olds, 19% in 45-49 year olds, 21% in 50-54 year olds, 27% in 55-59 year olds and 30% in 60-64 year olds.
The findings indicate that middle-age may be a critical life stage for interventions designed to prevent falls, according to the authors. The study incorporated the data from 19,207 men and women aged between 40 and 64 years. It has been recently published in the international journal PLOS ONE.
A study published in the Journal of Bone and Mineral Research shows that the risk of fractures increases by about 30 percent after a gastric bypass operation. It was also discovered that falls increase after these operations.
“Gastric bypass is a well-established method that has proven effective in reducing obesity, diabetes and mortality, so naturally our findings do not mean that you should stop providing these types of operations,” says Mattias Lorentzon, professor of geriatrics at Sahlgrenska Academy, University of Gothenburg, Sweden, and Chief Physician at the University Hospital.
The study is based on the records of 38,971 patients who underwent gastric bypass operations, of which 7,758 had diabetes and 31,213 did not. Those who had had the operation were compared with an equally large group of individuals who had not been operated on and who had the equivalent morbidity and background data.
Tennis elbow is also known as lateral epicondylitis. It occurs when a person strains the tendons in their forearm. People can usually treat tennis elbow at home with rest and over-the-counter medication. Doing specific exercises can also help ease the pain and prevent reoccurrence.
We describe eight exercises to help strengthen muscles in the forearm and prevent tennis elbow from coming back. We also cover causes and symptoms, home treatment, prevention, and when to see a doctor.
Before trying these exercises, wait for any swelling to go down. It is also a good idea to check with a doctor or a physical or occupational therapist first.
Pain in multiple sclerosis (MS) is a very common symptom. The goals of this CEU course is to examine the occurrence of pain in MS patients, to identify the pain conditions and the relationship to important demographic variables, and to determine its impact on quality of life. Also discussed in this course is the occurrence of central pain (CP) and its characteristics.
Dance participation, through its athletic nature can introduce risk of injury, but unlike sports, is not always recognized that specialist medicinal provision will assist in the mitigation of that risk. This CEU course examines the extent of injury in dance participation and the impact that specialist dance medicine provision has on overall dance injury incidence, determines the effects of a ballet class on the levels of inflammation markers, and reviews the development and evaluation of a dancer wellness program.
The human brain can take advantage of brain resources originally devoted to the hand to represent a prosthetic limb, a new UCL-led study concludes.
Among people with only one hand, the brain area that enables us to recognise hands can also recognise a prosthetic hand, particularly among those who use a prosthesis regularly, according to the new Brain paper.
The study provides the first account of how artificial limbs are represented in the brains of amputees.
“While the use of a prosthesis can be very beneficial to people with one hand, most people with one hand prefer not to use one regularly, so understanding how they can be more user-friendly could be very valuable,” said the study’s lead author, Dr Tamar Makin (UCL Institute of Cognitive Neuroscience).
Further evidence that doing aerobic exercise can preserve brain health and function — and thereby reduce the risk of dementia — is revealed in a study of older individuals with slight but noticeable declines in memory and thinking.
The researchers — from the University of Texas Southwestern Medical Center in Dallas — think that their study is the first to use an objective measure of aerobic capacity to assess the relationship between white matter integrity, cognitive performance, and cardiorespiratory fitness in older individuals with mild cognitive impairment (MCI).
“This research,” explains first study author Kan Ding, an assistant professor of neurology and neurotherapeutics, “supports the hypothesis that improving people’s fitness may improve their brain health and slow down the aging process.”