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Shoulder Hemiarthroplasty In Patients With Juvenile Idiopathic Arthritis

Shoulder Hemiarthroplasty In Patients With Juvenile Idiopathic Arthritis
Mike Cliff

Replacement of the berm in juvenile person idiopathic arthritis is not often performed and at that place rich person been no published series to date. We present nine glenohumeral hemiarthroplasties in eight patients with systemic or polyarticular adolescent idiopathic arthritis. The mean keep up-up was six days (59 to 89 months). The mean age at the time of operation was 32 old age. Surgery took place at a mean of 27 age subsequently diagnosis.

The results indicated excellent easing from painful sensation. At that place was restoration of useful office which deteriorated with time, in part because of progression of the systemic disease in this severely affected group. No patient has required revision to date and in that location has been no radiological evidence of laxation or osteolysis around the implants. We discuss the pathoanatomical challenges unique to this group. In that location was very little space for a prosthetic marijuana cigarette and, in some cases, bony deformity and the belittled size necessitated the wont of custom-made implants.

Arthritis of the shoulder joint is rarely an early feature of jejune idiopathic arthritis. Involvement of the hip joint and stifle is more common and can be treated by arthroplasty.’~8 That of the articulatio humeri is seen later in the course of ongoing systemic or polyarticular puerile idiopathic arthritis with an incidence of 15% at 15 eld from the onset of the disease.9 Persistent arthritis of the immature produces a maldeveloped proximal humerus and glenoid cavity (Fig. Later in the course of the disease, erosion of ivory and cartilage whitethorn cause medial migration and superior subluxation of the humeral head. Consequent dysfunction of the impairs basic daily activities such as toileting and the utilization of crutches or a stick, which English hawthorn be required during rehabilitation later surgical operation on the coxa or knee joint.

If the elbows become involved, the role of the upper limb deteriorates further. Another (case 6) complained of persistent paraesthesiae and annoyance affecting the lateral aspect of her forearm afterwards surgical procedure which did not respond to simple analgesia and physiotherapy. She remains unable to self-toilet effectively because of a poor range of movement and her purpose has deteriorated with time. Peripheral nerve-conduction studies were comparable with those of the contralateral arm and within normal limits. MRI of her cervical spine showed degenerative changes consistent with a C6 radiculopathy, merely she has declined further intervention.

Thither wealthy person been no other significant complications to date. This is a diminished series of patients with no unoperated control group other than the contralateral of four patients with significant arthritic involvement. Our methodology is otherwise reasonable.

About The Author:
Mike Cliff http://www.qualitymanual.net

Is Hair Transplant Painful?

Many people who think about having hair transplant surgery wonder if the procedure is painful. Often people have sensitive scalps and the thought of someone making cuts there seems hard to think about for these people. There is disagreement as to whether hair transplant surgery is painful, though.

Some say that hair transplant surgery is similar to a visit to the dentist. This does not seem like a description of something that is pain-free. It certainly does not seem like a relaxing experience. Yet some feel that there is that degree of pain involved.

The injections of the local anesthetic into the scalp before hair transplant procedures are definitely painful to some degree. Anyone who has had a tooth pulled knows that, if the tooth is deadened properly, it is not the tooth-pulling that hurts. It is the needle going in with medication to numb the tooth that is the real agony.

Of course, to follow the dental analogy, after the numbing wears off there is plenty of pain where the tooth was before. With hair transplant surgery, there is pain after the surgery as well. Swelling is normal after hair transplant surgery and can even keep you away from work. Your skull may feel very unusual for weeks.

However, the pain of hair transplant cannot actually be compared to a tooth extraction. Hair transplant pain is decidedly less sharp and some do not even feel it as pain at all. Many people simply feel it as an uncomfortable feeling. If they do feel any pain, it is of a degree that can be taken care of with a few doses of Tylenol.

On the other hand, some people who have had hair transplant procedures done do not feel that there is any pain involved at all. They tolerate the injections of the local anesthetic well. They are not bothered at all by the procedure. In fact they often watch television or read magazines, being awake and alert the whole time.

Hair transplant surgery is surely less painful than it was in earlier times when larger sections of scalp were excised. This involved more cutting to take out the donor hair and more cutting to insert the donor hair into the recipient site.

Hair transplant surgery was a very painful procedure in the past. Not all doctors today have given up on older methods. This is one reason why you should ask a lot of questions when you look for a hair transplant surgeon.

Up-to-date techniques for hair transplant use only the follicular unit and not a large amount of surrounding tissue for the donor grafts. This cuts down considerably on the amount of pain experienced. The procedure is minimally invasive now, so that no more of the scalp is disturbed than is necessary.

Finally, having a hair transplant with an experienced and skilled surgeon is an important key to having a less painful surgery. A doctor who knows the best way to do the procedure will cause you less pain an produce a better result for you into the bargain.

Searching for Osteoarthritis Pain Relief?

Searching for Osteoarthritis Pain Relief?
Kristy Haugen

Osteoarthritis or degenerative joint disease is a wear and tear disease of the joints typically seen in the older adult (usually over 60 years of age). Cartilage within the joints breaks down causing pain as the bones rub against each other. Osteoarthritis is commonly found in the knees, hips, hands, spine, and feet.
Obesity is a risk factor for developing osteoarthritis in the knees and hips. These weight bearing joints carry much of the weight causing increased wear and tear. Weight loss can significantly reduce the chance of developing osteoarthritis and can alleviate pain in people who currently have osteoarthritis.
Currently osteoarthritis treatment is limited because no medications are capable of preventing or retarding the disease process. Osteoarthritis treatment involves focusing on pain relief, the maintenance of quality of life, and functional independence. Let us take a look at some of the treatments that currently exist for osteoarthritis.
Many doctors recommend acetaminophen (Tylenol) as the initial analgesic (pain medication) of choice for the treatment of osteoarthritis. Acetaminophen has very few side effects. When using acetaminophen as a pain reliever, remember to follow the directions correctly. Acetaminophen is commonly overused by patients. You are recommended to not exceed 4,000 mg of acetaminophen in a twenty-four hour period. Acetaminophen is metabolized or processed by the liver. Excess acetaminophen can cause damage to the liver. Acetaminophen is also found in other pain medications such as Darvocet, Percocet, and Tylenol Cold. In fact, acetaminophen is found in quite a few prescription pain medications.
Traditionally NSAIDs (nonsteroidal anti-inflammatory drugs) have been useful in the treatment of osteoarthritis associated pain. One major concern with the use of NSAIDs is irritation to the stomach lining. In more severe cases, gastrointestinal bleeds or ulcers may form. NSAIDs can affect the bodys blood clotting ability and interfere with kidney function. NSAIDs should always be taken with food to decrease stomach irritation or upset. Do not drink alcohol while taking NSAIDs. However, these drugs should not be taken for extended periods of time unless directed otherwise by a qualified medical provider. Some common types of NSAIDs are ibuprofen (Advil), naproxen (Aleve), and aspirin.
Cyclooxygenase-2 inhibitors (COX-2 inhibitors) are a class of NSAIDs. COX-2 inhibitors suppress arthritis pain much the same way but with less stomach irritation. Many of us know of COX-2 inhibitors but not by this name. Vioxx (refecoxib), Celebrex (celecoxib), and Bextra (valdecoxib) are COX-2 inhibitors. Vioxx and Bextra have been removed from the market. These drugs can significantly increase the risk for stroke and heart attack. Celebrex remains on the market but does have a black box warning stipulating this drug also can increase the risk for cardiovascular events and gastrointestinal bleeding.
Capsaicin (Capsagel, Zostrix) which is derived from chili peppers can be applied topically for the treatment of osteoarthritis pain. Capsaicin will cause vasodilation, itching, and burning to the skin but after repeated applications desensitization will occur, decreasing ones pain. Methyl salicylate creams such as Ben-gay can also be used for osteoarthritis pain. Studies have shown that oral glucosamine and chondroitin supplements have a mild to moderate analgesic effect with arthritis.
For osteoarthritis patients who cannot tolerate their pain, glucocorticoid injections may be done. Glucocorticoids are similar to the hormone cortisol in the body. Glucocorticoids help alleviate pain by decreasing inflammation and swelling within the joint. Side effects are typically seen if you receive these injections too frequently.
Hyaluronan (viscosupplementation) injections can be injected directly into the joint for treatment of osteoarthritis. This medication helps supplement the synovial fluid. The synovial fluid is a lubricating fluid allowing the bones to move smoothly within the joint. This injection should relieve pain and improve your mobility of the joint. This treatment involves 3-5 shots within 5 weeks. You may experience pain and swelling after the injections but this should dissipate. Reduced osteoarthritis pain may last up to 6 months.
For patients that have decreased function and mobility of the joint, surgical intervention may be necessary. Surgical involvement should also be considered in patients whose pain has progressed to unacceptable levels. However, good surgical candidates are usually considered ideal for surgery. Certain health conditions can affect post-operative rehabilitation and healing. Surgery can hold just as much of a health risk as medications have side effects.
Osteoarthritis is not curable but there is hope for the future with advancements in medicine. Along with the above treatments for pain management, it is also important to remain active and healthy. Exercising regularly can help maintain mobility of the joint. Exercise also creates natural pain relievers such as endorphins. Pain may be a part of osteoarthritis, but pain doesnt have to be a part of your life!
Copyright 2006 Kristy Haugen

About The Author

Kristy Haugen is a mother working to finish her second bachelor degree in Chemical Engineering. She is also a Licensed Practical Nurse with a current bachelor degree in Biology and Chemistry. She writes to inform consumers about nutrition and health topics. Learn more about weight loss supplements at http://weightlosssupplements.vitaminmaniac.com. Learn more about vitamins and your health at http://blog.vitaminmaniac.com.

Fever in Children

The normal temperature of human body is 98.6F. If the temperature is taken rectally, the thermometer will show a rise of 1F, that is it will show 99.6F. The normal body temperature can vary slightly among individuals. The doctors consider the rise in body temperature as fever if it crosses the mark of 99.4F when taken orally and 100.4F when taken rectally. Rectal checking of temperature is done in infants and children who are older than four years have their temperature checked orally. Infants under three months should be rushed to the hospital if they have fever above 100.5F. The same applies for children older than three months and having a body temperature above 102F.

Digital thermometers provide a more accurate temperature reading. Mercury thermometers pose a health risk to the family as it is an environmental toxin. Hence, this is another good reason why mercury thermometers should be replaced with digital thermometers. Parents must take few measures before and during the task of checking the childs temperature. First of all, the parent should be sure about the kind of thermometer he or she wants to use, that is whether the thermometer should be meant for oral use or rectal use. The child shouldnt be bundled up very tightly before the temperature is checked. When the thermometer is being held by the child, the parent should supervise the whole procedure. Infants might experience pain when the thermometer is inserted into his rectum. Therefore, it is a good idea to cover the thermometers tip with petroleum jelly before insertion and only half of the thermometer should be inserted inside. The thermometer should be held until the beep is heard as children tend to drop the thermometer, if it is left to them. When taking the temperature orally, the thermometer should be placed underneath the tongue and should be left there until the beep is heard. After usage, the thermometer should be washed with cold water and soap.

When an infection is being fought by the body, it shows signs of fever. When the child becomes fussy and experiences aches in parts of the body, the child should be administered with some medicines. Medicines are available for children, depending on their needs, age and weight. The recommended dosage will be written on the pack or the label of the medicine and the parents should check that chart before giving any medicine to the child. If there is any kind of confusion, a doctor should always be consulted. Medicines like Acetaminophen, Ibuprofen, and Tylenol for children are available over the counter. When acetaminophen is given along with lukewarm bath, it helps decrease the fever. The medicine should be given just before the bath. The water shouldnt be cold and no alcohol products must be used while bathing. If bath is given minus acetaminophen, the child can begin to shiver and there is chance of body temperature going high again.

Aspirin is not advisable for children as it may develop serious illness called Reyes syndrome in the child. The risk is even more in kids having chickenpox or flu. Not more than five doses should be given in twenty four hours. If drops are given, the dropper should be filled till the marked line. A liquid medicine usually comes with a measuring device in the form of a cap. If not, it can be bought at the local drug store. Infants under four months shouldnt be given medicine, unless told by the doctor.

Certain symptoms call for immediate attention and the doctor must be contacted immediately. Symptoms can be dry mouth, rapid change in body temperature, ear-ache, behavioral changes, frequent diarrhea and vomiting, paleness, seizures, skin rashes, intense headaches, sore throat, swollen joints, irritability, high pitch crying, not feeling hungry, stiff neck, stomach ache, whimpering, wheezing, limpness, and breathing problems. At all times, the child must be made to wear comfortable cotton cloths which help the body to breath properly and at the same time absorbs the sweat. The child should also be given fluids constantly, in order to combat with dehydration.

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