Medicine
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Chronic knee pain is a common health issue that requires effective and noninvasive treatment. We devised a novel noninvasive approach using ultrasound-guided electrical nerve reactivation (ENR) in which ultrasound is used to identify the genicular nerve (GN). Then, transcutaneous low-frequency stimulation is applied for 10 seconds. The aim of this study was to clarify the pain-relieving effects of ENR on the GN innervating the knee joint. ⋯ This study is the first to demonstrate the effects of ultrasound-guided low-frequency stimulation of the GN for knee osteoarthritis. Although the exact mechanism of pain relief is unclear, we hypothesize that alterations in neurotransmission, with or without endorphin release, may play a role. Moreover, ENR may improve nerve entrapment by causing contraction of surrounding muscles.This study demonstrated that ultrasound-guided ENR targets the GN and effectively reduces pain without complications. This treatment addresses the limitations of invasive methods, such as hydrorelease and radiofrequency ablation. Furthermore, ultrasound-guided ENR has diverse applications in diagnostics, physical therapy, and pre-exercise pain management and will greatly benefit patients and healthcare professionals.
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There is currently no bibliometric analysis available regarding pain management (PM). The aim of this study was to monitor the advancement of the PM research field, demonstrate global productivity, identify the most highly cited studies, delineate collaborations between research areas and countries, and uncover new research topics and intriguing trends. A total of 16,216 articles on the subject of PM published between 1980 and 2023 were downloaded from the Web of Science database and analyzed using various bibliometric analysis methods. ⋯ In addition to Western countries with major economies in the field of PM (USA, Canada, Australia, and European countries), we identified China, India, and Turkey as research leaders. Our bibliometric analysis of 10,566 articles on PM reveals a significant growth in research, with recent trends focusing on e-health, telemedicine, virtual reality, and peripheral nerve blocks. These emerging technologies and personalized treatment approaches are shaping the future of PM.
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To investigate the determining risk factors for 1-year postoperative mortality in elderly patients with hip fracture and to assess the efficacy of the age-adjusted Charlson comorbidity index (ACCI) in predicting the risk of death. This study adopted a retrospective analysis method to focus on 652 elderly patients who underwent hip fracture surgery between January 2018 and November 2022 in our hospital. By systematically combing the patients' medical records, relevant data were collected and analyzed in depth for their association with morbidity and mortality rates within 1 year. ⋯ The ACCI excelled in predicting the risk of 1-year postoperative mortality, with an AUC of 0.912 for its prediction model and a specificity and sensitivity of 0.834 and 0.871, respectively, when the threshold was set at 5.5. The results of this study emphasize that age, ACCI, and postoperative pneumonia are key risk factors affecting the survival of elderly patients with hip fracture at 1-year postoperatively. ACCI, as an effective predictive tool, can provide an important reference for the clinical assessment of patients' postoperative risk and help precision medical decision-making.
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Cardiac papillary fibroelastoma (CPF) is a rare cardiac tumor that can lead to severe and potentially fatal complications such as stroke, myocardial infarction, and sudden cardiac death. The rarity of CPF makes it challenging for clinicians to diagnose and treat, highlighting the importance of timely and accurate diagnosis to prevent catastrophic outcomes. This case report aims to contribute to the clinical understanding of CPF involving the mitral valve (MV), providing insights into diagnosis and treatment strategies. ⋯ Echocardiography is a valuable diagnostic tool for identifying CPF and guide treatment decisions. This case emphasizes the importance of recognizing this rare valve tumor for timely clinical intervention.
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A vast amount of literature is available on the burden of acute ischemic stroke (AIS). Yet, most information on AIS burden does not stratify by stroke severity, and the inclusion of mild strokes (National Institute of Health Stroke Scale < 5) might obscure the true impact of moderate-to-severe AIS. Therefore, it is important to understand the literature as it pertains to the epidemiological, clinical, humanistic, and economic burden of moderate-to-severe AIS from a global perspective. ⋯ The review highlighted the huge burden of moderate-to-severe AIS, with patients experiencing worse outcomes with increased stroke severity. Further focus is needed on outcomes relating to moderate-to-severe AIS to fully understand the burden of stroke in this patient population.