Genicular Radiofrequency Ablation for Treatment of Post Total Knee Arthroplasty Posterior Thigh Pain: A Case Report.

We present a case of a 68-year-old woman with 6 months of chronic unilateral posterior thigh pain after a total knee arthroplasty. The patient's pain was refractory to various treatments. After appropriate diagnostic tests, a genicular nerve block and subsequent radiofrequency ablation were performed. These procedures provided substantial pain relief of her thigh pain at 3 months follow-up.

Patient Satisfaction with the New Interferon Beta-1b Autoinjector (BETACONNECT™).

INTRODUCTION: Multiple sclerosis (MS) typically requires life-long management with disease-modifying therapies (DMTs). Many DMTs require regular self-injection, and can be associated with injection site reactions, pain, and needle/injection phobia-but these can be addressed by improvements in autoinjector design. The aim of this study was to investigate patient satisfaction and preference for BETACONNECT™ (Bayer Pharma AG), a novel interferon beta-1b autoinjector. METHODS: Patients in Germany performing self-injections using BETACONNECT took part in the study. Data were collected through an online 15-min structured survey. Participants rated their experience with BETACONNECT on a 6-point scale and those satisfied with BETACONNECT were asked to describe the reason using a free-text box. RESULTS: One-hundred and eighteen patients with MS completed the survey. Ninety percent preferred BETACONNECT to their previous injection method (only 4% previously used manual injections, so most had previously used other autoinjectors). Ninety-two percent were very confident/confident in their ability to perform an injection using BETACONNECT. The most common free-text responses to "Why are you satisfied with the BETACONNECT™ autoinjector?" were ease of use (46%), less irritation/pain at the injection site (33%), and smoother injections (24%). Features considered most useful were automated injections (98%), adjustable injection speed (98%), and adjustable injection depth (98%). Ninety-seven percent thought it was easy to know when an injection was complete and 95% agreed/strongly agreed it was easy to learn to use the autoinjector. Seventy-three percent agreed that the quietness and effortlessness of the BETACONNECT reduced their level of injection anxiety, 92% that its size and shape makes it easy to handle during injections, and 67% that it decreases injection site pain. Eighty percent of those using the reminder function thought they were less likely to miss an injection. CONCLUSION: Patients with MS self-injecting interferon beta-1b expressed a high level of satisfaction and preference for BETACONNECT. Thus, BETACONNECT represents a valid option to improve patients' overall injection experience. FUNDING: Bayer HealthCare Pharmaceuticals.

Excessive sleepiness and self-reported shift work disorder: an Internet survey of shift workers.

OBJECTIVES: To compare excessive sleepiness and quality of life (QoL) scores in shift workers who report having a diagnosis of shift work disorder (SWD) with those who report having no such diagnosis. METHODS: An Internet-based survey was conducted between March and April 2009 that included shift workers with or without a self-reported diagnosis of SWD. Participation required working ≥ 21 hours/week for 2 weeks prior, a diagnosis of SWD or a score of ≥ 10 on the Epworth Sleepiness Scale, and a score of ≥ 5 on any subscale of the Sheehan Disability Scale. RESULTS: Surveys included 260 shift workers (103 with an SWD diagnosis and 157 without an SWD diagnosis). Diagnosed and undiagnosed respondents demonstrated similar Epworth Sleepiness Scale (13.7 vs 13.6, respectively) and Karolinska Sleepiness Scale (6.0 vs 5.5, respectively) scores. Sheehan Disability Scale social life and family life scores were similar between the 2 groups, although diagnosed respondents had a greater mean Sheehan Disability Scale work disability score compared with undiagnosed respondents (6.7 vs 5.5; P < 0.0001). Quality of life was more impaired in diagnosed patients in terms of ability to drive safely, propensity for accidents, work performance, and anxiety (P ≤ 0.039 vs undiagnosed). Work-related accidents (16% vs 5%; P = 0.0076) and injuries at work (17% vs 7%; P = 0.0233) were also reported by more diagnosed respondents than by undiagnosed respondents. Many respondents used caffeine and 57% of diagnosed respondents received prescription medication to treat symptoms of SWD. CONCLUSION: Individuals with diagnosed SWD demonstrated impairment in QoL and reported more work-related accidents and injuries, although many measures of QoL and prescription drug use were similar between groups. Shift work disorder is underrecognized by clinicians and patients, resulting in undertreatment, despite the availability of several behavioral and therapeutic treatment options.