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robotic single site surgery (R-SSH) is a novel technique, which may be superior to conventional multiport hysterectomy in select patients regarding cosmesis and postoperative pain. We, perform a randomized trial to compare R-SSH with multiport laparoscopic hysterectomy with regard to the postoperative rehabilitation, cosmesis, the operational cost, and the perioperative morbidity.
More research is needed to investigate methods of pain control for cervical preparation for abortion procedures. Women report pain with paracervical block injection as well as with osmotic dilator placement. This study seeks to compare a 12 mL, 2-site 1% plain lidocaine paracervical block for pain control during cervical preparation (osmotic dilator insertion) for Dilation and Evacuation (D&E) to a 20 mL 1% lidocaine 2-site paracervical block.
The purpose of this study is to learn if using an Interspace between the Popliteal Artery and Capsule of the Knee (iPACK) injection technique (also called a "nerve block") that numbs the nerves going to the back part of the knee to aid in physical therapy after surgery. The iPACK technique uses a numbing solution (local anesthetics) that is injected behind the knee to reduce pain and to help straighten the knee. This block may affect movement in the leg and make the legs weak, but thing is rare. A few institutions use the iPACK block for patients having total knee replacements, with the hope of providing good pain relief combined with improved mobility after surgery.
In addition to fatigue, pain is the most frequent and persistent symptom following breast cancer and breast cancer treatment. Despite the effectiveness of different physical therapy modalities, such as manual techniques, passive mobilizations and exercises, many patients still experience pain and subsequent difficulties in daily functioning at short and long term. Past decades, the awareness on the important role of educational interventions in the management of pain in general has increased. Educational interventions aim at explaining and improving the knowledge, control and attitude of the patient regarding his/her pain complaint. However, these educational interventions are often restricted to more biomedical pain management instructions and general advice on physical activity and analgesics (= traditional biomedical education). Only recently, increased knowledge on pain mechanisms led to a more modern educational approach. This modern approach is suited to explain more complex issues associated with pain and takes into account many more factors related to pain. To our knowledge, only one controlled trial investigated the effectiveness of a modern educational intervention in the early stage of breast cancer treatment. The results were very promising for shoulder function. However, only short-term effects were examined, no randomization was performed and no pain-related and socio-economic outcomes were evaluated. Therefore, the aim of the proposed project is to investigate the effectiveness of a similar modern educational program, in addition to standard physical therapy care, in the early treatment phase of breast cancer in comparison with traditional biomedical education. A randomized controlled trial will be performed with a long-term follow up period. The primary outcome parameter is pain-related disability. Secondary outcomes are different dimensions of pain, physical and mental functioning, return to work and health-care related costs.
Transcranial magnetic stimulation (TMS) is a procedure that has been shown to improve pain in chronic sufferers. It is a well-tolerated procedure that can be performed on an outpatient basis. It uses a plastic covered coil that sends a magnetic pulse through the skull into the brain and by targeting particular areas in the brain it can be used to help modulate the perception of pain. The study intends to use this technique to treat such a disabling symptom in patients who suffer from Parkinson's Disease (PD). Initially the aim is to study this technique in ten patients who are suffering from pain and have PD. These patients would initially require an MRI scan which allows us to map the brain and target the correct brain areas for the delivery of the stimulation. The stimulation would be performed over ten sessions and the patients would be assessed by a clinician using well recognized clinical tools. It is anticipated that there will be a meaningful improvement in pain. It is also anticipated that TMS is a safe technique to use in patients with PD. The study will be used to help plan a future study that compares TMS with sham technique to prove whether TMS could be an option in the treatment of such a disabling condition.
Osteoarthritis (OA) in the knee is characterized by chronic inflammatory pain that is not necessarily related to the amount of joint damage. Clinical practice guidelines recommend physical activity (PA) for osteoarthritis pain, but most adults with OA do not engage in PA. One reason for this is that while PA can reduce OA related joint pain, it does not work for everyone. PA decreases pain sensitivity for about half of adults with OA but increases pain sensitivity for the other half. The investigators are hypothesizing that individual differences in how well cells work to make energy, inflammation, and different proteins available in blood cells explains who PA will work to reduce pain and who it won't among adults with OA. The purpose of this pilot study is to determine if blood cells' ability to make cellular energy, inflammation and proteins help explain the difference about who PA reduces activity for and who it doesn't. The investigators will compare these biologic factors and pain sensitivity before walking, immediately after 30 minutes of walking (i.e. "acute") and after six weeks of walking three times a week for 30 minutes (i.e. "long-term") in adults with hip or knee osteoarthritis. The investigators will also compare these results to adults without OA. The investigators will recruit a sample of 40 adults with radiologic (e.g x-ray or CT scan) evidence of hip or knee OA and 20 age/gender matched healthy adults without OA to address the following study aims: Aim 1: To examine the effects of a six week (three days/week) walking program on pain in adults with OA as compared to healthy controls. Aim 2: To test the cells' ability to make energy as a mechanism for variation in pain after "acute" and "long-term" PA in older adults with lower extremity osteoarthritis. Aim3: To test the role of inflammation as a mechanism for variation in pain after "acute" and "long-term" physical activity in adults with lower extremity osteoarthritis. Aim 4: To generate hypotheses regarding the role of proteomics in variation in pain after "acute" and "long-term" physical activity.
Patients experience discomfort from lidocaine injections. Vibrating kinetic anesthesia devices have been shown to reduce pain of injections in dentistry, pediatrics, and dermatology, though no studies of lidocaine injections in sites common to dermatologic surgery exist. We will conduct a randomized split-body study, in which healthy volunteers will rate the pain of lidocaine injections on a visual analog scale, with and without the vibrating kinetic anesthesia device being used during injection
JJ ureteral stents are often positioned at the end of a ureteroscopy and often cause important comorbidities. Indeed, up to 80% of the patients complain a deterioration of the quality of life. In order to reducing the symptoms to the minimum, the producing companies developed different types of stents, hypothetically thinking that modifications in materials and designs might reduce patients' discomfort. Classic ureteral stents have a proximal J and a distal J as anchors respectively in the kidney and in the bladder. Talking about materials, most ureteral stents are made up of polymers, especially polyurethane and its derivatives, and silicon. Next to these ones, producing companies have also designed metallic or mixed stents in order to reducing radial resistance. In literature there are not many studies that adequately make a comparison of the symptoms related to the different types of stents. In particular, there are not many comparing symptoms caused by traditional hydrophilic Vortek JJ and symptoms caused by silicone JJ. From 2008 an Italian version of USSQ is at disposal in order to evaluating with a standard method the symptoms reported by patients after ureteral stent positioning. Aim of this study study is comparing prospectively in a randomized way symptoms of patients with traditional hydrophilic Vortek JJ and symptoms of patients with silicone JJ by submitting USSQ to the patients who undergo a URS with laser lithotripsy for ureteral lithiasis.
JJ ureteral stents are often positioned at the end of a ureteroscopy and often cause important comorbidities. Indeed, up to 80% of the patients complain a deterioration of the quality of life. In order to reducing the symptoms to the minimum, the producing companies developed different types of stents, hypothetically thinking that modifications in materials and designs might reduce patients' discomfort. Talking about materials, most ureteral stents are made up of polymers, especially polyurethane and its derivatives. Classic ureteral stents have a proximal J and a distal J as anchors respectively in the kidney and in the bladder. Different types of ureteral stents have been proposed along the years in order to improving the efficacy and reducing the complications. As long as the bladder J has been identified as one of the determining factors of the low tolerance to stents, other shapes and designs were proposed along the years to reduce the impact of the distal end. In particular, one type of stent was designed by substituting the distal J with a double loop in order to reducing the bladder impact. Literature related to efficacy of bladder double loop in reducing symptoms caused by stent positioning and in improving comfort in comparison with a traditional hydrophilic Vortek JJ are extremely limited. From 2008 an Italian version of USSQ is at disposal in order to evaluating with a standard method the symptoms reported by patients after ureteral stent positioning. Aim of this study study is comparing prospectively in a randomized way symptoms of patients with bladder double loop stent and symptoms of patients with traditional hydrophilic Vortek JJ by submitting USSQ to the patients who undergo a RIRS with ureteral sheath and laser lithotripsy for renal lithiasis.
This study attempts to verify whether different types of catheters could impact on patients' feelings at the first-time catheter insertion at urodynamic study. Each patient will undergo an insertion of only one type of a catheter and will rate his/her pain and discomfort feelings.