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Biomedical subjects

R Boas

Publications and source records attributed to R Boas.

5 recordsLinked to original sources
PubMed1998

Complex Regional Pain Syndromes: guidelines for therapy.

This report aims to present an orderly approach to the treatment of Chronic Regional Pain Syndrome (CRPS) types I and II through an algorithm. The central theme is functional restoration: a coordinated but progressive approach that introduces each of the treatment modalities needed to achieve both remission and rehabilitation. Reaching objective and measurable rehabilitation goals is an essential element. Specific exercise therapy to reestablish function after musculoskeletal injury is central to this functional restoration. Its application to CRPS is more contingent on varying rates of progress that characterize the restoration of function in patients with CRPS. Also, the various modalities that may be used, including analgesia by pharmacologic means or regional anesthesia or the use of neuromodulation, behavioral management, and the qualitatively different approaches that are unique to the management of children with CRPS, are provided only to facilitate functional improvement in a stepwise but methodical manner. Patients with CRPS need an individual approach that requires extreme flexibility. This distinguishes the management of these conditions from other well-described medical conditions having a known pathophysiology. In particular, the special biopsychosocial factors that are critical to achieving a successful outcome are emphasized. This algorithm is a departure from the contemporary heterogeneous approach to treatment of patients with CRPS. The underlying principles are motivation, mobilization, and desensitization facilitated by the relief of pain and the use of pharmacologic and interventional procedures to treat specific signs and symptoms. Self-management techniques are emphasized, and functional rehabilitation is the key to the success of this algorithm.

Algorithms↗
PubMed1995

Reflex sympathetic dystrophy: changing concepts and taxonomy.

We present a revised taxonomic system for disorders previously called reflex sympathetic dystrophy (RSD) and causalgia. The system resulted from a special consensus conference that was convened on this topic and is based upon the patient's history, presenting symptoms, and findings at the time of diagnosis. The disorders are grouped under the umbrella term CRPS: complex regional pain syndrome. This overall term, CRPS, requires the presence of regional pain and sensory changes following a noxious event. Further, the pain is associated with findings such as abnormal skin color, temperature change, abnormal sudomotor activity, or edema. The combination of these findings exceeds their expected magnitude in response to known physical damage during and following the inciting event. Two types of CRPS have been recognized: type I, corresponds to RSD and occurs without a definable nerve lesion, and type II, formerly called causalgia refers to cases where a definable nerve lesion is present. The term sympathetically maintained pain (SMP) was also evaluated and considered to be a variable phenomenon associated with a variety of disorders, including CRPS types I and II. These revised categories have been included in the 2nd edition of the IASP Classification of Chronic Pain Syndromes.

Causalgia↗
PubMed1984

Laser trabeculoplasty. A prospective study of treatment variables.

Forty-five phakic eyes with open-angle glaucoma and uncontrolled intraocular pressure underwent laser trabeculoplasty. Each eye was assigned randomly to one of three treatment groups: group 1, 100 spots over 360 degrees; group 2, 50 spots over 180 degrees; or group 3, 50 spots over 360 degrees. A 50-micron spot was aimed at the anterior meshwork; power and time were varied to achieve a blanch. Forty-four eyes were followed up for at least four weeks without further intervention. The mean IOP before therapy and the initial IOP elevation were similar in all groups. After four weeks, the mean IOP reductions in 15 eyes in group 1, 15 eyes in group 2, and 14 eyes in group 3 were not significantly different. However, significantly more eyes in group 1 demonstrated a greater than 12 mm Hg reduction in IOP than eyes in the other groups. Group 2 tended to have the fewest eyes with reduced medications.

Aphakia↗
PubMed1984

Prognostic features in laser trabeculoplasty.

Of 59 phakic eyes with open-angle glaucoma initially treated with laser trabeculoplasty, 45 eyes were followed at least 6 months. Intraocular pressure (IOP) at 6 months was less than 22 mmHg in 37 (82%), of which 25 (81%) were on fewer medications; of 26 eyes followed at least 12 months, IOP was less than 22 mmHg in 24 (92%). Of 49 eyes of patients over 55 years, 43 (88%) had a final IOP less than 22 mmHg, significantly (P less than 0.01) greater than 5/10 eyes of patients under 55 years. Initial IOP correlated positively with reduction of IOP (r = 0.66). IOP was measured 1 h after treatment in 42 eyes, of which 11 (26%) rose greater than or equal to 8 mmHg. This pressure elevation did not significantly affect the success rate.

Argon↗