Musculoskeletal pain is a common reason for patients visiting hospitals or clinics. Various therapeutic tools including oral medications, physical modalities, and procedures have been used to alleviate musculoskeletal pain. Numerous clinical trials have been conducted to demonstrate the therapeutic effect of each treatment and compare the efficacy of different protocols. These trials were conducted under controlled conditions with specific endpoints and timeframes, and the individual constraints of each patient were not considered. We believe that the findings of such studies may not accurately reflect clinical reality in real-world settings. In this article, we propose treatment principles for patients in pain clinics. We propose two principles for pain treatment: first, “Healing, in the end, is not healing.” and second, “The patient’s job is not a patient.” The main role of pain physicians is to quickly and actively reduce pain and help patients focus on their work and lives.
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Protocol for lower back pain management: Insights from the French healthcare system Lea Evangeline Boyer, Mathieu Boudier-Revéret, Min Cheol Chang World Journal of Clinical Cases.2024; 12(11): 1875. CrossRef
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Background Recently, there have been various developments in medical service robots (MSRs). However, few studies have examined the perceptions of those who use it. The purpose of this study is to identify user perceptions of MSRs.
Methods We conducted a survey of 320 patients, doctors, and nurses. The contents of the survey were organized as follows: external appearances, perceptions, expected utilization, possible safety accidents, and awareness of their responsibilities. Statistical analyses were performed using t-test, chi-square test, and analysis of variance.
Results The most preferred appearance was the animal type, with a screen. The overall average score of positive questions was 3.64±0.98 of 5 points and that of negative questions was 3.24±0.99. Thus, the results revealed that the participants had positive perceptions of MSR. The overall average of all expected utilization was 4.05±0.84. The most expected utilization was to guide hospital facilities. The most worrisome accident was exposure to personal information. Moreover, participants thought that the overall responsibility of the robot user (hospital) was greater than that of the robot manufacturer in the case of safety accidents.
Conclusion The perceptions of MSRs used in hospital wards were positive, and the overall expected utilization was high. It is necessary to recognize safety accidents for such robots, and sufficient attention is required when developing and manufacturing robots.
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Background Trigeminal neuralgia (TN) is a severe, paroxysmal pain in the distribution of the fifth cranial nerve. Microvascular decompression (MVD) is the most widely used surgical treatment for TN. We undertook this study to analyze the effects of and complications of MVD and to refine the surgical procedure for treating TN.
Methods A total of 88 patients underwent for TN underwent surgery at our hospital. Among them, 77 patients underwent MVD alone, and 11 underwent partial sensory rhizotomy (PSR) with or without MVD. The medical records of these patients were retrospectively analyzed for patient characteristics, clinical results, offending vessels, and complications if any.
Results The mean follow-up duration was 43.2 months (range, 3–216 months). The most common site of pain was V2+V3 territory (n=27), followed by V2 (n=25) and V3 (n=23). The most common offending vessels were the superior cerebellar artery and anterior inferior cerebellar artery in that order. The overall rate of postoperative complications was 46.1%; however, most complications were transient. There were two cases of permanent partial hearing disturbance. In the MVD alone group, the cure rate was 67.5%, and the improvement rate was 26.0%. Among 11 patients who underwent PSR with or without MVD, the cure rate was 50.0%, and the improvement rate was 30.0%.
Conclusion The clinical results of MVD were satisfactory. Although the outcomes of PSR were not as favorable as those of pure MVD in this study, PSR can be considered in cases where there is no significant vascular compressive lesion or uncertainty of the causative vessel at the surgery.
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Revisiting the Efficacy of Redo Microvascular Decompression for Trigeminal Neuralgia Zhongding Zhang, Hua Zhao, Yinda Tang, Baimiao Wang, Qing Yuan, Ying Zhang, Yihua Li, Jun Zhong, Shiting Li World Neurosurgery.2024; 186: e335. CrossRef
A systematic review on the efficacy of adjunctive surgical strategies during microvascular decompression for trigeminal neuralgia without intraoperative evidence of neurovascular conflict Nicola Montano, Grazia Menna, Alessandra Musarra, Renata Martinelli, Alessandro Izzo, Quintino Giorgio D’Alessandris, Manuela D’Ercole, Alessandro Olivi Neurosurgical Review.2024;[Epub] CrossRef
Progress in Surgical Treatment of Trigeminal Neuralgia 滨 何 Advances in Clinical Medicine.2023; 13(02): 2313. CrossRef
How Far Has Radiofrequency Thermocoagulation Come Along as a Treatment Procedure in Treating Trigeminal Neuralgia Patients? Stephen D Howard, Varun Soti Cureus.2023;[Epub] CrossRef
Historical aspects of the problem of treatment of trigeminal neuralgia and the role of neurosurgical methods in its solution (literature review) A. N. Zhurkin, A. V. Semenov, V. A. Sorokovikov, N. V. Bartul Acta Biomedica Scientifica.2021; 6(4): 123. CrossRef
Trigeminal Neuralgia: Current Approaches and Emerging Interventions Risheng Xu, Michael E Xie, Christopher M Jackson Journal of Pain Research.2021; Volume 14: 3437. CrossRef
Background It is not possible to measure how much activity is required to understand and code a medical data. We introduce an assessment method in clinical coding, and applied this method to neurosurgical terms.
Methods Coding activity consists of two stages. At first, the coders need to understand a presented medical term (informational activity). The second coding stage is about a navigating terminology browser to find a code that matches the concept (code-matching activity). Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT) was used for the coding system. A new computer application to record the trajectory of the computer mouse and record the usage time was programmed. Using this application, we measured the time that was spent. A senior neurosurgeon who has studied SNOMED CT has analyzed the accuracy of the input coding. This method was tested by five neurosurgical residents (NSRs) and five medical record administrators (MRAs), and 20 neurosurgical terms were used.
Results The mean accuracy of the NSR group was 89.33%, and the mean accuracy of the MRA group was 80% (p=0.024). The mean duration for total coding of the NSR group was 158.47 seconds, and the mean duration for total coding of the MRA group was 271.75 seconds (p=0.003).
Conclusion We proposed a method to analyze the clinical coding process. Through this method, it was possible to accurately calculate the time required for the coding. In neurosurgical terms, NSRs had shorter time to complete the coding and higher accuracy than MRAs.
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Are ICD codes reliable for observational studies? Assessing coding consistency for data quality Stuart J. Nelson, Ying Yin, Eduardo A. Trujillo Rivera, Yijun Shao, Phillip Ma, Mark S. Tuttle, Jennifer Garvin, Qing Zeng-Treitler DIGITAL HEALTH.2024;[Epub] CrossRef