Effectiveness of enhanced pulse oximetry sonifications for conveying oxygen saturation ranges: a laboratory comparison of five auditory displays

British Journal of Anaesthesia, 2017; 1–7, DOI 10.1093/bja/aex343

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Changes in Anxiety and Depression Are Mediated by Changes in Pain Severity in Patients Undergoing Lower-Extremity Total Joint Arthroplasty.

Background: Depression and anxiety are common comorbidities in chronic pain including osteoarthritis patients undergoing total joint arthroplasty (TJA). What is not clear is whether psychiatric comorbidity precedes the manifestation of painful states or represents a reaction to living with chronic pain and associated functional impairment. The objective of this research was to explore whether decreases in depressive and anxiety symptoms after lower-extremity TJA could be due to postsurgical reductions in pain. Methods: We conducted a secondary analysis of data from 1448 TJA patients enrolled in the Analgesics Outcome Study. Patients completed measures of pain intensity, functional status, and depressive and anxiety symptoms preoperatively and at 3 and 6 months postoperatively. Data were analyzed using a structural equation modeling approach. Results: We found that improvement in pain and physical function from baseline to 6 months postoperatively was associated with improvement in depression and anxiety symptoms. We also found that a change in overall body pain at 3 months after surgery significantly mediated changes in both the depression and anxiety scores at 6 months after surgery even when controlling for age, sex, baseline body pain, education, opioid use, and type of surgery. Conclusions: Presurgical affective symptoms not only have an effect on change in postsurgical pain, whereby lower preoperative scores on depression and anxiety were associated with lower postsurgical pain, but also postsurgical decreases in pain were associated with lower levels of depression and anxiety after surgery. Taking these points into consideration may prove useful in working toward better outcomes for TJA. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Microbioma and probiotics: from gut to Mars

Publication date: Available online 27 October 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Bruno Acatauassú Paes Barreto




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Ustekinumab treatment of pityriasis rubra pilaris: A report of five cases

Abstract

Pityriasis rubra pilaris (PRP) is a rare, chronic, inflammatory skin disease of unknown etiology. Patients refractory to conventional therapies have been treated successfully with biologic drugs such as anti-tumor necrosis factor agents. Recently, a role of the interleukin-23/T-helper 17 axis in PRP has been described. Our objective was to assess the effectiveness of ustekinumab in five patients with adult-onset PRP refractory to conventional therapies. In the present study, four patients had type I and one patient type II adult-onset PRP. They were treated with three s.c. doses of ustekinumab at weeks 0, 4 and 16. Clinical response was evaluated monthly during treatment up to a 15-month follow-up period. All patients promptly showed a decrease in erythema, follicular hyperkeratosis and scaling. After three injections, complete remission of skin lesions was achieved in four out of five cases and a significant clinical improvement was shown in one case. To the best of our knowledge, this is the largest case series reported on ustekinumab treatment in PRP. Our results, in addition to previous studies from other groups, suggest that ustekinumab may be a possible first-line treatment for PRP patients refractory to conventional therapies.

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Unilateral rhinorrhoea: An atypical aetiology

Publication date: Available online 27 October 2017
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): C. Aussedat, C. Dorbeau, D. Bakhos




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Virtual Presurgical Planning Optimizes the Outcome for a Patient with Ameloblastoma

By the time 31-year-old Marcus King saw Ron Karni, MD, and Kunal Jain, MD, the ameloblastoma encompassed the majority of... Read the full article...

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Dr. Amber Luong Recognized for Clinical Excellence by UTHealth’s Women Faculty Forum

Amber Luong, MD, PhD, associate professor of otorhinolaryngology and research director for the department, has been recognized with the 2017... Read the full article...

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