bluuebunny/crossref_metadata_2025 huggingface dataset:
Применение белковой смеси для лечебного питания у пациентов с раком желудка
Authors: Гасанова У.Ф.
Published: October 2024

Введение. Рак желудка остается одной из самой распространенных форм злокачественных опухолей человека. При хирургическом лечении у пациентов с раком желудка важная роль принадлежит устранению белково-энергетической недостаточности. Цель. Сравнение результатов лабораторных исследований у пациентов с раком желудка, получавших белковую смесь во время хирургического лечения. Материалы и методы. Клинические результаты изучены у 95 пациентов, в том числе 52 лиц основной группы, получавших лечебное питание, и 43 пациентов, получавших только стандартное питание. Результаты. При поступлении пациентов уровень общего белка, альбумина и трансферрина в обеих группах был одинаковым. С 1-го дня после операции и до выписки уровень общего белка в основной группе был выше, чем в группе сравнения. При обследовании пациентов через месяц лечения отмечалась разница в уровнях общего белка, альбумина и трансферрина. Общий белок в основной группе составил 3,5 г/л, альбумин – 3,8 г/л, трансферрин – на 0,4 г/л выше, чем в группе сравнения. Заключение. При использовании белково-композитной смеси в лечебном питании у пациентов с раком желудка во время хирургического лечения количество белка, трансферрина и альбумина заметно увеличилось.

Introduction. Gastric cancer remains one of the most common forms of malignant tumors in humans. In patients with gastric cancer during surgical treatment an important role belongs to the elimination of protein-energy deficiency. Purpose. Comparison of laboratory test results in patients with gastric cancer who received a protein mixture during surgery. Materials and methods. Clinical outcomes were investigated in 95 patients Including 52 main group patients who received therapeutic nutrition and 43 comparison group who received only standard medical nutrition. Results. Upon admission of patients, the level of total protein, albumin and transferrin in both study groups was the same. From the 1-st day after surgery until discharge, total protein levels in the main group were higher than in the comparison group. When examining patients after one month treatment a difference was noted in the levels of total protein, albumin and transferrin. Total protein in the main group was 3.5 g/l, albumin was 3.8 g/l, transferrin was 0.4 g/l higher than in the comparison group. Conclusion. The use of protein composite mixture in medical nutrition for patients with gastric cancer during surgical treatment, amount of protein, transferrin and albumin were increased.
Analisis Implementasi Sistem Penilaian Kinerja Pegawai Pada Badan Kepegawaian Dan Pengembangan Sumber Daya Manusia
Authors: Opel Saputra  , Heliyani
Published: October 2024

Penelitian ini bertujuan untuk menganalisa implementasi sistem penilaian kinerja pegawai pada Badan Kepegawaian Dan Pengembangan Sumber Daya Manusia (BKPSDM) Kota Payakumbuh. Metode penelitian yang digunakan adalah kualitatif metode deskriptif dan data dikumpulkan melalui wawancara mendalam, observasi ataupun dokumentasi. Informan dalam penelitian ini adalah pejabat dan pegawai ada di lingkungan BKPSDM Kota Payakumbuh sebanyak 5 orang. Hasil penelitian menyimpulkan bahwa: 1) BKPSDM Kota Payakumbuh menggunakan aturan baru dari Peraturan Menteri PANRB No. 6 Tahun 2022 untuk menilai kinerja pegawai. Penilaian dilakukan berdasarkan uraian pekerjaan masing-masing pegawai, menjadikannya lebih objektif dan fokus pada kontribusi nyata terhadap tujuan organisasi; 2) BKPSDM Kota Payakumbuh belum mengimplementasikan sistem penilaian kinerja yang sesuai dengan Peraturan Menteri PANRB Nomor 6 Tahun 2022; 3) Implementasi sistem penilaian kinerja di BKPSDM Kota Payakumbuh menghadapi hambatan seperti kurangnya komitmen pegawai, budaya sungkan dalam penilaian, subjektivitas, fokus administratif, indikator perilaku yang tidak akurat, dan tumpang tindih sistem penilaian. Hambatan-hambatan ini mengurangi efektivitas dalam mendukung pengembangan karier dan manajemen kinerja optimal. Hasil penelitian merekomendasikan pihak BKPSDM Kota Payakumbuh untuk menerapkan sistem penilaian kinerja sesuai Peraturan Menteri PANRB No. 6 Tahun 2022. Langkah penting mencakup pelatihan pegawai, pembaruan uraian pekerjaan, umpan balik rutin, penggunaan hasil untuk pengembangan profesional, dan evaluasi berkala. Sistem ini harus memiliki indikator konkrit dan transparansi untuk menilai pegawai secara adil, sehingga dapat meningkatkan kinerja dan efisiensi organisasi.
The Influence of Brand Image, Price Perception, and Local Wisdom-Based Promotional on Buyer's Decision
Authors: Nopera Tesi , Putri Dini Elida , Hasibuan Anggy Qurnia Raafy
Published: October 2024

This study analyzes the influence of brand image, price perception, and local wisdom-based promotional strategies on the purchasing decisions for Tebo Riski Danang batik in Tebo Regency, Jambi Province. Tebo batik is unique, and Rumah Batik Riski Danang stands out by producing and marketing it, highlighting the region's history and distinctiveness. The research employed a quantitative method with questionnaires distributed to 255 respondents in Tebo Tengah District. The analysis included validity, reliability, correlation, and multiple linear regression. The findings revealed that brand image negatively impacts purchasing decisions, while price perception has a positive influence. However, the promotional strategy does not significantly affect purchasing decisions. Simultaneously, the three variables together significantly influence purchasing decisions. Brand image, price perception, and promotional strategy explain 41.4% of the variation in purchasing decisions, with other factors accounting for the remaining 58.6%. In conclusion, brand image and price perception are crucial in shaping purchasing decisions for Tebo Riski Danang batik, while the promotional strategy has no significant impact.
A Study on the Actual Conditions and Improvement Measures of Correctional Nursing
Authors:   The Correction Welfare Society of Korea, Lee Dong Im , Chun Jung Hwan
Published: October 2024

Correctional medical personnel in prisons are recognized as workplaces that do not want to work due to low wages, insufficient medical facilities at the clinic level, and stigma of hate facilities, and are always insufficient from the past to the present. The lack of correctional medical personnel can negatively affect the treatment of inmates and lead to poor quality of medical services. In particular, orthodontists do medical treatment unrelated to their major, so the recipients do not trust the orthodontists' treatment and want video or external treatment. However, video or external treatment must be performed at a designated time with cooperative hospitals on an appointment date, so inmates may not be able to receive timely treatment. The lack of correctional medical personnel is causing an excess of work because correctional nurses have to take over for work. Therefore, the purpose of the study is to present practical and effective alternatives to expanding medical personnel.
The scope of the study is to understand the actual state of prison correctional medical care based on previous studies, correctional statistics, and Internet data, and to derive various problems through this to find countermeasures. The countermeasure is to provide concrete and practical alternatives so that it can contribute to the expansion of correctional medical personnel.
As a result of the study, in order to solve the shortage of orthodontic medical personnel, AI doctors and pharmacists are introduced and operated in the medical department of orthodontic facilities. Another option is to first introduce a traveling pharmacist system for orthodontic pharmacists, so that one orthodontic pharmacist is in charge of three to four correctional facilities. Next, rather than hiring correctional doctors only, correctional facilities with many elderly inmates are also hired and operated by oriental doctors. Finally, in order to hire excellent orthodontic nurses, it is necessary to allow correction facilities and schools to cooperate to conduct nursing practice in the medical department of orthodontic facilities so that they can understand and publicize the specificity of correction so that they can provide a lot of support when hiring.
Sürdürülebilir İnsani Kalkınma ve Kent Bağlamında Çevresel Sürdürülebilirliğin Dinamikleri: Semiparametrik Panel İkili Nitel Tercih Modelinden Kanıtlar
Authors: Acar Tuğçe
Published: October 2024

Son yıllarda kentleşme, altyapı gelişimi, endüstriyel süreçler ve iklim değişikliğinin çevresel bozulmaya önemli boyutta yansımaları bulunmaktadır. Bu yansımaların olası olumsuz etkileri doğrultusunda uygulanacak politikaları ve genel eğilimleri belirlemek oldukça önemlidir. Belirlenen uygun politika ve eğilimler kentsel planlamaya ve insani kalkınmaya yönelik de önemli bilgiler sağlamaktadır. Öte yandan alandaki çalışmalar sağlık ve refahı desteklemek adına gerek doğal kaynakları gerekse küresel ekosistemi korumak için yüksek düzeyde çevresel farkındalık yaratmak ve kentsel sürdürülebilirlik ve sürdürülebilir insani kalkınma hakkında bilgiye erişimi sağlamak konusunda öncü niteliğe sahiptir. Bu doğrultuda çalışmada çevresel sürdürülebilirlik üzerinde çeşitli faktörlerin etkisini anlamak için uygun bir ekonometrik model olan STIRPAT (The Stochastic Impacts by Regression on Population, Affluence and Technology) yaklaşımında değişkenler belirlenmiştir. Sürekli değişken olarak nüfus, teknoloji ve refah temsili değişkenlerin yanında Kyoto değişkeni, bölgesel ve gelir düzeyinde inceleme için eklenen kukla değişkenler ile ekolojik ayak izi ilişkisini keşfetmek amaçlanmıştır. Bu amaçla analizde parametrik yaklaşımın varsayımsal sınırlamalardan kaçınılarak, olasılık yoğunluk fonksiyonu vasıtası ile veri setinin gerçekte sahip olduğu fonksiyonel formun belirlenmesine imkan tanıyan semiparametrik panel ikili nitel tercih modeli tahmininin gerçekleştirilmesine odaklanılmıştır. 2000-2018 yıllarını kapsayan 2565 gözlemlik veri seti ile küresel ölçekte 135 ülke için inceleme gerçekleştirilmiştir. Tahmin sonuçları doğrultusunda, atık yönetim stratejilerinin ve geri dönüşüm gibi iklim dostu faaliyetlerin geliştirilmesi gerekliliğine, verimli teknoloji ve kaynak tahsisi içeren ekonominin üretken yapısına vurgu yapılmış, bulguların sürdürülebilir kentsel yeniden gelişim konusunda mevcut karar verme sürecini çevreleyen belirsizliği azaltmak için yol gösterici olduğu belirtilmiştir.
Family support for management of hypertension
Authors: Kurnia Vera , Pauzi Muhammad , Gusmiati Rita , Wahyuni Sri
Published: October 2024

Background: The phenomenon that occurs in hypertension patients in the internal medicine room at Dr. Achmad Darwis Suliki Hospital is that the family is not involved in managing hypertension management because the family does not know about hypertension management.Purpose: The research purpose is to examine the relationship between family support and hypertension management at homeMethods: This research uses a quantitative type with a descriptive correlation and design using a cross-sectional approach. Data collection started from October to February 2022 in the internal medicine room at Dr. Achmad Darwis Suliki Hospital with a sample of 67 respondents using an accidental sampling technique. The data collection tool used a questionnaire and was analyzed using the chi-square test.Results: The results of the study that there was a relationship between family support and hypertension management at home (p = 0.000 and OR = 18.889), with an Odds Ratio value of 18.889 so that respondents whose families supported hypertension management had 18.9 times the chance of carrying out hypertension management well.Conclusion: The family has an important role in hypertension management, family support is a motivation for sufferers to carry out hypertension management well. Health workers are expected to always educate families of hypertension sufferers so that they are involved and play an active role in carrying out hypertension management at home so that they can control blood pressure and preventive measures for the occurrence of complications in hypertension sufferers.
The Effect of Warm Water Compress on the Vagina on the Healing of Perinium Wounds in Post Partum Mothers
Authors: Fetrisia Wiwit , Esterina Ulfa , Sari Meka Melani , Ismul Ismul , Firdawati Firdawati
Published: October 2024

Background: Based on data from the World Health Organization (WHO) in 2017, around 830 women died every day due to complications during pregnancy or childbirth. In Indonesia, 75% of women who give birth vaginally experience perineal wounds and some of these wounds have the potential to become infected. In the Tanjung Emas Community Health Center working area, out of 23 post partum mothers, 4 people (27%) experienced slow wound healing. One cause of infection is poor perineal care. The cause of the high infection rate is due to a decrease in the body's resistance in mothers who are susceptible to infection. To reduce the risk of maternal death globally from 216.1 million live births in 2015 to 70 per 100,000 live births in 2030.Purpose:The purpose of this research is to determine the effect of warm water compresses on the vagina on healing perineal wounds in post-partum mothers. Methods: The design of this research is a two-group post test only control group design. The population in this study was all postpartum mothers (0-40 days) from December-March 2024 who gave birth in the Tanjung Emas Community Health Center Working Area, namely 23 people. The sampling technique used is a non-probability sample using the sampling technique method in this research using purposive sampling, namely 8 intervention groups and 8 control groups.Results: The results of this study were that the average wound healing was 5.5 and in the Control Group 6.5 days with a mean difference of 1 day and SD = 0.926. The results of calculations using the Paired T-Test showed p value = 0.039 (p 0.05), which means Ho is rejected and Ha is accepted, meaning there is a significant influence between the effect of warm water compresses on the vagina on healing perineal wounds.Conclusion: Further research may be carried out to develop research on other effective methods for healing perineal wounds in pregnant women.
SUSTAINABILITY IN SOCIAL ENTREPRENEURSHIP: INTERVENTIONS TO REDUCE POVERTY AND INEQUALITY IN EMERGING ECONOMIES: A PRISMA APPROACH
Authors: Ogbari Ejos Mercy , Ingomowei Preye Samson , Amaihian Augusta Bosede
Published: October 2024

Emerging economies, often characterized by significant social and economic disparities, provide a critical context for examining how social entrepreneurs can drive sustainable development to reduce poverty and inequality. It has been identified that developing countries are facing numerous economic, social, and bio-environmental problems, such as income disparity, unequal access to education, unemployment, information asymmetry, and corruption. In response to these identified problems, this study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach to investigate the sustainability of social entrepreneurship in the context of poverty and inequality interventions in emerging countries. Studies were selected through identification, screening, eligibility, and analysis. The findings underscore the potential of social entrepreneurship to contribute significantly to sustainable development goals by fostering inclusive growth and reducing disparities in areas of poverty and inequality in emerging economies; the findings can help researchers, practitioners, social entrepreneurs, and governments make strategic investment decisions and overcome challenges in poverty and inequity. Several recommendations for future research are underscored, including the need to conduct more studies to better understand social entrepreneurship and poverty and inequality reduction.
Instrumenty prawne, instytucjonalne i pomocowe Unii Europejskiej oraz UNHCR w walce z kryzysem uchodźczym i humanitarnym na Ukrainie w latach 2022–2023
Authors: Węc Janusz Józef
Published: October 2024

The European Union and its Member States have managed the refugee and humanitarian crisis triggered by Russian aggression against Ukraine much more effectively than the refugee and migration crisis of 2015–2016. Instead of scrambling to find new institutional arrangements, the European Union has relied on existing but undervalued or dormant legal and institutional instruments, such as the Temporary Protection Mechanism, the Integrated Crisis Response Mechanism at political level and the EU Civil Protection Mechanism. As in the 2015–2016 crisis, UNHCR made an important contribution to monitoring the refugee and humanitarian crisis in Ukraine and providing assistance to refugees.
Kwestia transformacji relacji UE-Rosja w dyskursie politycznym przywódców państw Grupy Wyszehradzkiej
Authors: Zheltovskyy Vadym
Published: October 2024

The main purpose of the article is to analyze the transformation of EU-Russia relations in the political discourse of the Visegrad Group leaders in the context of Russia’s full-scale military aggression against Ukraine. Based on the analysis of selected speeches, the author focuses on explaining the style of political leadership of the prime ministers from V4 countries and on the main elements of the presented assumptions regarding the transformation of the European Union’s foreign policy. Particular attention is paid to the issue of future format of EU-Russia relations, as well as to the issue of EU enlargement. For this purpose, a comparative analysis of the leadership style evolution of the main actors (both institutional and individual) from the European Union and the Visegrad Group countries was carried out in relation to the issue of cooperation with Russia in 2014–2022 and after the full-scale Russian invasion that took place on February 24, 2022.
Bałkany Zachodnie – wyzwania dla bezpieczeństwa w obliczu wojny Rosji w Ukrainie
Authors: Domachowska Agata
Published: October 2024

The Western Balkans is a region that has been aspiring to join the European Union for years. However, this process is prolonged due to the often insufficient involvement of individual governments in the actual implementation of reforms, but also of the EU itself, which did not express a real desire for enlargement. Russia’s invasion of Ukraine seems to be an additional strong incentive to reactivate the region in order to prevent it from becoming an arena of foreign, including Russian, influence. Russia is particularly interested in deepening conflicts and destabilizing the situation in the region in order to prevent the Western Balkans from joining the EU. The aim of this article is to analyze the current situation in the countries of the region, after the outbreak of the Russian war in Ukraine, in the context of potential challenges for the security of the Western Balkan countries.
Stosunki niderlandzko-rosyjskie w kontekście inwazji na Ukrainę
Authors: Żelichowski Ryszard
Published: October 2024

The Kingdom of the Netherlands is the only Western state, a member of the European Union, which has tense relations with Russia comparable to Polish-Russian ones after 2010. They have collapsed because of air disasters on the Russian controlled territories. Although the way they were played by politicians of both countries in a different manner, the final results were similar – close to zero. In the years 2011–2014, bilateral relations were going well, and their climax was reached during the winter Olympics in Sochi. The annexation of Crimea in 2014 worsened them. The Netherlands joined the sanctions announced against Russia. The collapse of the relations of the Kingdom of the Netherlands with Russia took place at the end of May 2018. It was the result of the shooting down of the Malaysia Airlines passenger aircraft (code: MH-17) over the Donetsk region on its route from Amsterdam to Kuala Lumpur route. It caused the death of 298 people on the board. The international investigation team found Russia guilty of this barbarian act. As a result of the trial, the Dutch courts ruled the fault of three people and sentenced them to life imprisonment.Diplomatic relations of the Netherlands with Ukraine were established in 1992. Since the Russian invasion of the Kingdom of the Netherlands, the policy of supporting Ukrainians in the fight against the invader has been consistent. The Dutch government favors a hard approach to Russia. The Netherlands participates in the economic sanctions of the European Union towards this country. The Dutch government offers Ukraine significant humanitarian, military and financial assistance. In 2024 it will reach an amount of around 2 billion Euro. The resignation of the government of Prime Minister Mark Rutte in September 2023 will not change the principles of foreign policy of the state, regardless of the composition of a new cabinet, almost all parties still want to continue the support of Ukraine.
Revised stratigraphic position of a volcanic-ash-derived maximum depositional age in the Lower Cretaceous McMurray Formation
Authors: Durkin Paul R. , Rinke-Hardekopf Lucian
Published: October 2024

The stratigraphic framework developed for the McMurray Formation and Wabiskaw Member of the Clearwater Formation (Aptian, Lower Cretaceous) provides a consistent nomenclature and allows for correlation across the Athabasca Oil Sands Region. Event horizons (e.g. volcanic ash layers) within the stratigraphic framework provide crucial geochronologic ages that constrain the timing of deposition and improve upon biostratigraphic estimations. Here, we provide recognition criteria for genetic depositional units in the Firebag sub-basin with the intent of revising the stratigraphic position of a previously published volanic ash-derived maximum depositional age of 115.07 +/– 0.16 Ma. Results demonstrate that the previous placement of this event horizon at the top of the B1 parasequence set was not consistent with the accepted definition of the McMurray Formation–Wabiskaw Member boundary or application of the stratigraphic framework. Here, we establish that the ash-bearing coal horizon is at the top of the A2 parasequence set/channel belt of the McMurray Formation. The implications of this change include constraining the age of the A2 channel belt system to approximately 115 Ma which, under the previous study, would have been younger and unconstrained. We also discuss the implications for our understanding of the Aptian-Albian boundary in the context of allogenic drivers and global environmental change at that time.
Profil pasien refluks laringofaring di RSUP Prof. Dr. R. D. Kandou Manado
Authors: Runtung Maureen , Pelealu Olivia C. P. , Pontoh Valentini M.
Published: October 2024

Abstract: Diagnosis of laryngopharyngeal reflux (LPR) requires a clinical history based on clinical symptoms (Reflux Symptom Index - RSI) and laryngeal examination (Reflux Finding Score - RFS) due to its nonspecific symptoms and laryngoscopic signs do not always correlate with the severity of symptoms. This study aimed to obtain the profile of patients with LPR at Prof. Dr. R. D. Kandou Hospital. This was a retrospective and descriptive study using medical records of LPR patients at Prof. Dr. R. D. Kandou Hospital during the period 2020-2022. The results showed that the majority of LPR patients were females (57.6%), aged 41-65 years and occupation as housewife. The most commonly experienced complaints were difficulty in swallowing (36.3%) and feeling of throat tightness (25,0%). The most frequent endoscopic finding was erythema/hyperemia of the arytenoids (36.8%). In conclusion, laryngo-pharyngeal reflux is often experienced by females aged 41-65 years, occupation as housewife. The most common complaints are difficulty in swallowing and feeling of throat tightness. Erythema/hyperemia of the arytenoid has the highest percentage in endoscopic finding.
Keywords: laryngopharyngeal reflux; patient profile
 
Abstrak: Dalam mendiagnosis refluks laring faring (RLF), diperlukan anamnesis berdasarkan gejala klinis (Reflux Symptom Index - RSI) dan pemeriksaan laring (Reflux Finding Score - RFS) karena gejalanya tidak spesifik dan tanda laringoskopi tidak selalu sesuai dengan tingkat keparahan gejala. Penelitian ini bertujuan untuk mendapatkan profil pasien RLF di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif menggunakan data pasien yang tercatat di Instalasi Rekam Medis RSUP Prof. Dr. R.D. Kandou Manado periode 2020 hingga 2022. Hasil penelitian mendapatkan bahwa mayoritas pasien RLF ialah perempuan (57,6%) dengan usia 41-65 tahun. Distribusi pekerjaan menunjukkan jumlah pasien tertinggi ialah ibu rumah tangga. Keluhan yang paling sering dialami ialah sulit menelan (36,3%) dan rasa mengganjal pada leher (25,0%). Temuan endoskopi paling sering ialah eritema/hiperemis aritenoid (36,8%). Simpulan penelitian ini ialah refluks laring faring sering dialami oleh perempuan pada usia 41-65 tahun, dengan pekerjaan sebagai ibu rumah tangga. Keluhan paling sering ialah sulit menelan dan rasa mengganjal di tenggorokan. Distribusi tertinggi pasien refluks laring faring berdasarkan kondisi laring ialah eritema/hiperemis aritenoid.
Kata kunci: refluks laringofaring; profil pasien
Guía de evaluación en la formación de educadores infantiles: Estrategias y herramientas
Authors: Pherez Gustavo , Vargas Sonia , Melo Erika , Niño Leidy
Published: October 2024

La educación es el cimiento sobre el cual se construyen las sociedades del futuro, y en esa base, el rol del educador es fundamental. Esta guía surge con el propósito de proporcionar a los profesionales en formación, herramientas sólidas y actualizadas que les permitan cumplir con los altos estándares que la calidad educativa exige en el contexto colombiano. Basada en las normativas del Ministerio de Educación Nacional (MEN) y en los rigurosos lineamientos de la Asociación Acreditadora Adventista (AAA), esta obra no solo busca satisfacer las demandas académicas, sino también aportar a la formación integral de los educadores, quienes se proyectan a enseñar a las generaciones más jóvenes.
Alleviation of COVID-19 Parosmia with Stellate Ganglion Block: A Case Report
Authors: Uhlenhopp Richard
Published: October 2024

BACKGROUND: An estimated 23 million people in the United States are affected with Long COVID, formally called Postacute Sequelae SARS-CoV-2 infection (PASC). Disturbances of taste and smell are common symptoms. There is limited evidence for effective treatment. CASE REPORT: A 68-year-old woman contracted COVID-19 in January 2021. She had worsening parosmia and dysgeusia, described as “rancid” smells with a variety of foods and objects. She underwent successful right stellate ganglion block in April 2022. Immediately after the procedure, she was able to comfortably eat food previously intolerable. Benefits persisted at 5- and 30-day follow-up. CONCLUSIONS: An ever-expanding patient population and lack of treatment options emphasize the importance of continued research into the pathogenesis and treatment of PASC. A nascent body of evidence suggests stellate ganglion block may provide durable relief. KEY WORDS: COVID-19, PASC, Long COVID, parosmia, stellate ganglion block, case report
Delayed Hypersensitivity Reaction to Iodinated-Contrast Following Lumbar Epidural Steroid Injection: Case Report
Authors: Cai Viet
Published: October 2024

BACKGROUND: Delayed hypersensitivity reactions to an iodinated radiologic contrast are a form of hypersensitivity reactions that occurs anywhere from one hour up to 10 days after exposure to the causative agent. CASE REPORT: We present a case of a 54-year-old woman with a history of a single minor reaction to an intravenous iodinated contrast consisting of only abdominal pain who developed a maculopapular exanthema 7 days after exposure to iohexol, an iodinated radiological contrast, during a lumbar epidural steroid injection. The patient was later treated with topical betamethasone with resolution of cutaneous symptoms within 2 weeks. The patient then underwent patch testing, which revealed a positive result for palladium (II) chloride; to date, there has been no documented association in the literature between palladium (II) chloride and iohexol. CONCLUSION: DHRs to an iodinated radiologic contrast can range from cutaneous manifestations to lethal presentations, such as Stevens-Johnson syndrome and toxic epidermal necrolysis, with the most common form being a maculopapular exanthema as experienced by our patient. Testing can be performed to determine the causative agent of the DHR and to find an alternative agent if a radiologic contrast is required. Caution must be taken if using an alternative contrast agent as there is significant cross-reactivity to other iodinated radiologic contrasts. KEY WORDS: Delayed hypersensitivity reaction, iodinated contrast, maculopapular exanthema, palladium, case report
Spinal Cord Stimulator Migration and Malfunction in the Setting of Upper Extremity Complex Regional Pain Syndrome: A Case Report
Authors: Miniato Mohammed
Published: October 2024

BACKGROUND: Common long-term complications for neuromodulation include lead migration, loss of efficacy of therapy, and lead malfunction. The following case describes pitfalls of lead migration and preventative steps to decrease risk of this complication. CASE REPORT: This is an independent case study following the outcome of one patient diagnosed with complex regional pain syndrome that had failed conservative therapy. She underwent implantation of a spinal cord stimulator (SCS) with > 90% relief. Loss of relief was described on follow-up. On reimaging, the SCS had migrated cephalad and this was likely the cause of the malfunction. CONCLUSIONS: Lead migration can occur at any time, even years after initial implantation. Recommendations from the literature and gained from this case include heightened vigilance and suspicion when a patient encounters sudden failure of pain relief, low threshold for new imaging to assess lead location, and use of mechanical anchoring devices. KEY WORDS: Neuromodulation, spinal cord stimulator, CRPS, chronic regional pain syndrome, pain, chronic pain, case report
Post-Spinal Cord Stimulator Implantation Effects on Normalization of Blood Glucose and Oxygen Saturation in Complex Regional Pain Syndrome: A Case Report
Authors: Palkyi Tenzin
Published: October 2024

BACKGROUND: Spinal cord stimulation (SCS) has consistently been shown to improve quality of life and reduce pain in patients with complex regional pain syndrome (CRPS). Nevertheless, the extent of its potential benefits has yet to be completely elucidated. CASE REPORT: This case follows a patient who developed CRPS in her right wrist following a fall from her wheelchair. She experienced severe disruption to her quality of life. Multiple conservative treatment modalities failed to alleviate her symptoms. After successfully completing an SCS trial and receiving an implant, the patient’s symptoms and quality of life improved significantly. Additionally, her blood glucose and oxygen saturation readings improved in the affected extremity after undergoing SCS. CONCLUSION: Normalization of blood glucose and oxygen saturation levels is not a deeply studied effect from SCS treatment. More research is encouraged to understand the mechanisms under which these results arise and how they can benefit patients’ outcomes. KEY WORDS: Spinal cord stimulator, complex regional pain syndrome, causalgia, wrist pain, case report
Portuguese Man O’ War-induced Sural Compression Neuropathy: A Case Report
Authors: Crock Lara
Published: October 2024

BACKGROUND: The Portuguese man o’ war (Physalia physalis) is an organism that lives in semitropical areas of the Atlantic Ocean, including off the coast of the United States. It has long tentacles extending far beyond the organism that pose a risk to swimmers. The most common symptoms of envenomation include local reactions at the site of injury, but systemic effects are possible with significant venom burden. Long-term effects are uncommon, but persistent cutaneous changes have been described. CASE REPORT: A 46-year-old woman presented with persistent shooting, burning left lower extremity pain following contact with a Portuguese man o’ war one year prior. CONCLUSION: Here we report a case of persistent sural compression neuropathy following envenomation by a Portuguese man o’ war responsive to conservative management including medications for neuropathic pain, physical therapy, and sural nerve blocks. KEY WORDS: Sural nerve compression, jellyfish sting, Portuguese man o’ war, envenomation, compression neuropathy, case report
Genicular Nerve Radiofrequency Ablation Before and After Magnetic Resonance Imaging Anatomical Mapping: Case Study
Authors: Hillery Terence
Published: October 2024

Background: Chronic knee pain is a significant cause of morbidity for which radiofrequency ablation (RFA) of genicular nerves (GN) may be considered. However, treatment effectiveness depends on accurate placement of RFA probes, and there remains uncertainty on GN anatomical location. Case Report: A 21-year-old man presented with 2 months of severe knee pain following a canoe trip. Hoffa’s fat impingement was diagnosed with magnetic resonance imaging (MRI), and a subsequent fat pad injection was unsuccessful. After GN blocks, RFA provided 90% relief for 4 weeks. At this time, RFA was performed with probe placement determined by the patient’s MRI-mapped GN neurovascular bundle location. At 8 weeks, the patient continues to have 100% left knee pain relief. Conclusion: This case suggests that MRI-mapped GNs may assist in planning genicular RFA to improve probe and nerve apposition. Key words: Genicular nerve, magnetic resonance imaging, radiofrequency ablation
A Nocardia brasiliensis Infection Secondary to a Loxosceles reclusa Bite: A Spinal Cord Stimulation Case Report
Authors: Provenzano David
Published: October 2024

Background: Nocardia brasiliensis, an uncommon human pathogen, is rarely seen in infections secondary to insect bites or stings. However, Nocardia brasiliensis can infect an individual through an ulcerative wound, such as one mediated by the phospholipase D toxin immune response following a Loxosceles reclusa (i.e., brown recluse spider) bite. Case Report: This report presents the case of a patient who underwent a spinal cord stimulator (SCS) trial with an unknown brown recluse spider bite on her left foot. We describe the Nocardia brasiliensis cutaneous infection following a brown recluse bite and the effective management of the infection through long-term antibiotic use, which allowed for the eventual successful implantation of the SCS. Conclusion: The present case urges health care providers to conduct thorough, full-body examinations prior to any surgical procedure to identify and treat all remote infections prior to SCS implantations, as advised by the Neurostimulation Appropriateness Consensus Committee’s recommendations for infection prevention. Key words: Nocardiosis, Loxosceles reclusa, Nocardia brasiliensis, spinal cord stimulation, case report
Medically Challenging Case: Lumbosacral Radiculopathy Secondary to Occlusion of Right Iliac Vein Kissing Stent in the Context of Variant Course of Right Iliac Vein between Psoas Muscle and Spine and Factor V Leiden Mutation
Authors: Lu Lei , Selassie Meron
Published: October 2024

Background: The variant course of the right iliac vein between the right psoas muscle and spine and its significance has not been reported and lumbosacral radiculopathy is not a known complication after occlusion of the right iliac vein stent in such condition. Case Report: The patient is a 38-year-old woman with Factor V Leiden mutation, multiple deep vein thrombosis, including in her bilateral iliac veins, and a variant course of the right iliac vein between the psoas muscle and spine, who presented with radicular pain and weakness after stenting of the bilateral iliac veins. She was found to have complete occlusion of the right common iliac through the femoral vein stent that was compressing her lumbosacral spinal roots and resulted in lumbosacral radiculopathy. Her pain and weakness significantly improved after an epidural steroid injection. Conclusion: Lumbosacral radiculopathy is a rare complication after occlusion of the right iliac vein stenting in the setting of a variant course of the right common iliac vein between the psoas muscle and spine and Factor V Leiden mutation. The risks and benefits of implanting a kissing stent in a similar scenario should be weighed carefully for patients at high risk for stent occlusion. Additionally, patients should be assessed for variable anatomy as part of the presurgical workup to hopefully prevent this undesired outcome. Key words: Lumbosacral radiculopathy, iliac vein stenting, Factor V Leiden, deep venous thrombosis, variant course
Intrathecal Drug Delivery System in Chronic Low Back Pain: Case Series
Authors: Neto Jorge Taqueda
Published: October 2024

Background: Modern science says that persistent low back pain is the main cause of years lived in disability. Among pain management approaches, we highlight the intrathecal drug delivery system (IDDS). The aim of this observational study was to assess pain intensity in a series of cases of patients with chronic low back pain using IDDS. Case Series: This is a series of cases with 14 patients affected by chronic degenerative spinal disease using IDDS. Regarding age, an average of 81.57 (SD ± 7.44) was obtained, in addition, everybody reported being retired, having at least completed high school, with failure of conservative treatment, and none were smokers. Conclusion: Patients with chronic degenerative spine disease responded successfully to the IDDS treatment, obtaining pain relief in 100% of patients through the Numeric Rating Scale, which enabled a moderate quality of life on average and mild/moderate disability in most of the sample. Key words: Drug delivery systems, indicators of quality of life, low back pain
Knee Osteoarthritis Treated by Ultrasound-guided Genicular Nerve Block Combined with IPACK Block: Case Report
Authors: Li Renshu
Published: October 2024

Background: The prevalence rate of knee osteoarthritis (KOA) in China ranks first among all types of OA. A nerve block is a crucial intervention method for treating the pain of KOA patients in the early and middle stages. This paper aims to analyze the mechanism of ultrasound-guided genicular nerve block (GNB) combined with infiltration between the popliteal artery and capsule of the knee (IPACK) block in treating KOA pain by reporting the diagnosis and treatment of a KOA patient. Case Report: The patient, a 71-year-old woman, complained of “intermittent knee joint pain for several years, aggravated and with limited mobility for one month” and was treated in the outpatient department of the Yanbian University Hospital. After a physical and auxiliary examination, it was diagnosed as bilateral KOA, Kellgren-Lawrence level II, and GNB combined with IPACK block was proposed. Conclusion: GNB can achieve analgesia in front of the knee joint, eliminate aseptic inflammation and edema of patella medial plica (PMP), and assist with postoperative rehabilitation exercise, which is conducive to early improvement of lower limb function. IPACK block has a good analgesic effect behind the knee joint. The combination of GNB and IPACK block may play an essential role in future KOA pain treatment. Key words: Case report, genicular nerve block, IPACK block, knee, osteoarthritis, ultrasound-guided
Anatomically-Guided Botulism Toxin Injections for Enhanced Abdominal Muscle Relaxation Prior to Massive Inguinal Hernia Repair: A Case Report
Authors: Kamyszek Reed
Published: October 2024

BACKGROUND: The use of botulism toxin A (BTA) to augment abdominal muscle relaxation for surgical hernia repair is well described. However, guidance on the anatomic considerations to facilitate safe and ideal abdominal wall BTA injection patterns is limited. CASE REPORT: A 37-year-old man presented with a 26-cm inguinal hernia and abdominal content loss of domain. Due to high risk of incomplete abdominal closure, abdominal compartment syndrome, and prolonged postoperative ventilatory support, a multidisciplinary approach to surgical closure was sought with therapeutic input from a comprehensive pain clinic. The patient was injected with BTA into the bilateral internal and external oblique muscles 2 weeks preoperatively. The injection pattern design employed anatomic considerations for points of maximum abdominal wall tension and anticipated BTA spread. Subsequent muscle paralysis facilitated successful surgery with minimal tension upon closure. CONCLUSION: This case supports the safe and effective use of BTA for enhanced abdominal wall relaxation prior to major inguinal hernia repair. When considering BTA therapy for abdominal muscle relaxation augmentation, the choice of injection pattern should include points of maximum tension and injections of close-enough proximity for BTA spread and overlap to maximize procedure benefit, regardless of the location or type of abdominal wall hernia repair. KEY WORDS: Botulism toxin, abdominal muscle relaxation, hernia repair, inguinal hernia, regional anesthesia, case report
Treatment of Low Back Pain Elicited by Middle Cluneal Neuralgia: Case Report and Literature Review of Interventional Treatments
Authors: Reeh Colton
Published: October 2024

BACKGROUND: Cluneal neuralgia is increasingly becoming recognized as an etiology of low back pain. The majority of the literature on cluneal nerve interventions describes modalities targeting the superior cluneal nerves with little emphasis on the middle cluneal nerves. CASE REPORT: A 21-year-old woman with a medical history of congenital myelomeningocele with tethered cord at L5-S1, status post 3 decompressive releases, presented to the clinic with chronic low back pain and associated sacroiliac paresthesia. Over 11 months, she underwent 7 ultrasound-guided bilateral middle cluneal nerve blocks, without corticosteroid, resulting in significant, immediate pain relief sustained for 4 to 6 weeks. CONCLUSIONS: A nerve block with local anesthetic has proven to be therapeutic for middle cluneal neuralgia, but with varying long-term efficacy. The use of radiofrequency ablation, peripheral nerve stimulation, regenerative medicine, and alcohol neurolysis have shown promise as long-term therapeutic options and as a substitute for invasive surgical release. KEY WORDS: Alcohol neurolysis, cluneal nerve block, middle cluneal neuralgia, peripheral nerve stimulation, prolotherapy, radiofrequency ablation, tethered cord
Efficacy of Dorsal Root Ganglion Stimulation for Chronic Pain in Leprosy: A Case Report
Authors: Short Kristin
Published: October 2024

BACKGROUND: Leprosy is a chronic infectious disease that can be associated with refractory neuropathic pain. Neuromodulation with dorsal root ganglion stimulation (DRGS) represents a novel potential therapeutic option for the nonpharmacological management of leprosy-associated chronic pain. CASE REPORT: We present a case of a leprosy-associated chronic lower extremity neuropathic pain in a 56-year-old man managed with DRGS. The patient underwent implantation of DRG electrodes at the left L5 and right S1 levels for refractory lower extremity pain. Following the procedure, reported significant reduction in pain intensity, decreased analgesic requirements, and improved functionality at short-term follow-up, with no reported postprocedure complications. CONCLUSIONS: The successful treatment of post-leprosy neuropathic pain with DRGS contributes to the expanding body of evidence supporting the use of neuromodulation in the management of treatment-refractory pain. We suggest that DRGS may be a viable interventional option for chronic neuropathic pain from leprosy and other potential indications. KEY WORDS: Dorsal root ganglion stimulation, neuromodulation, chronic pain, leprosy, case report
Cryoablation of Peripheral Nerves for Treatment of Pain Secondary to Intracranial Tumors: A Case Report
Authors: Rakesh Neal
Published: October 2024

BACKGROUND: Management of cancer-related pain is an important public health issue, with significant impacts on patient quality of life. Interventional techniques for pain relief, such as perineural catheters, are widespread in clinical practice, allowing the reduction of reliance on morphine. However, their use can result in difficulties, such as catheter dislodgement, leading to a loss of efficacy. Alternative techniques may therefore be advantageous. One such technique is the perineural injection of botulinum toxin (BoNT), a neurotoxin with motor blocking properties, which is reported to exert long-term analgesic effects. CASE REPORT: Herein, we describe 2 cases of patients with refractory cancer-related pain, of differing origin, treated by perineural BoNT injection. In both cases, medium-term analgesic effects were achieved from a single injection. CONCLUSION: These case reports add to the growing literature on the use of BoNT for cancer-related pain relief, and support calls for future randomized clinical trials in this area. KEY WORDS: Botulinum toxin, cancer-related pain, perineural block, interventional pain management.
Peripheral Nerve Stimulation with High-Frequency Electromagnetic Coupling (HF-EMC) at the Posterior Tibial and Common Peroneal Nerves for the Treatment of Chronic Lower Limb Pain: Case Report
Authors: LaFleur J. Lance
Published: October 2024

BACKGROUND: Chronic lower limb pain due to mononeuropathy can be highly debilitating, affecting quality of life both physically and psychosocially. Attention around peripheral nerve stimulation has heightened in recent years due to increasing data demonstrating positive outcomes in chronic pain management. This study discusses a case of chronic lower limb pain managed effectively with peripheral nerve stimulation of 2 key nerves in the lower extremity: the posterior tibial and common peroneal. CASE REPORT: A 68-year-old man presented with squeezing and crushing pressure encasing the entire left foot and ankle, with paresthesias along the heel and arch while walking and sharp radiating pain at the medial ankle and along the arch when sitting. In addition, 3 to 4 evenings per week, episodes of sharp radiating pain between the calf and ankle would occur for several hours. The average foot and ankle pain was 7 of 10 on the Verbal Rating Scale (VRS), with the evening calf episodes averaging 10 of 10. Previous therapies included nonsteroidal anti-inflammatory drugs (NSAIDS), nerve blocks, nerve ablation, opioids, spinal cord stimulation (SCS), and intrathecal drug delivery, all of which resulted in minimal, temporary relief. After successful diagnostic nerve blocks, peripheral nerve stimulators were placed at the posterior tibial and common peroneal nerves providing significant relief. CONCLUSION: Subthreshold peripheral nerve stimulation at the posterior tibial and common peroneal nerves has proven successful for a patient suffering from chronic, debilitating lower limb pain due to mononeuropathy; results included decreased chronic pain and fewer pain episodes as well as increased activity, better socialization, and a significantly improved quality of life. KEY WORDS: Ankle, chronic pain, common peroneal, foot, lower limb, mononeuropathy, peripheral nerve stimulation, posterior tibial