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definition of pain

Christopher Rowe, Eric Vittinghoff, Glenn-Milo Santos, Emily Behar, Caitlin Turner, Phillip Coffin
OBJECTIVES: Opioid overdose mortality has tripled in the USA since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events...
October 20, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
J C Menon, J K Joseph, M P Jose, B L Dhananjaya, O V Oommen
INTRODUCTION: Snakebite is an occupational hazard causing considerable morbidity and mortality worldwide, particularly so in tropical countries like India. OBJECTIVE: The aim of this study is to (i) review the demographic, clinical and laboratory findings in patients (1051) admitted with venomous snakebite (ii) to correlate mortality, morbidity and duration of hospital stay with clinical signs, symptoms and laboratory parameters. METHODS: A retrospective study of 1051 patients treated for snakebite over 10 years (2000 - 2009) in Little Flower Hospital, Angamaly, Kerala...
August 2016: Journal of the Association of Physicians of India
Cheal Wung Huh, Sung Ill Jang, Beom Jin Lim, Hee Wook Kim, Jae Keun Kim, Jun Sung Park, Ja Kyung Kim, Se Joon Lee, Dong Ki Lee
Common bile duct (CBD) stones are generally associated with greater elevations of alkaline phosphatase and gamma-glutamyl transpeptidase levels than aspartate aminotransferase and alanine aminotransferase levels. However, some patients with CBD stones show markedly increased aminotransferase levels, sometimes leading to the misdiagnosis of liver disease. Therefore, the aim of this study was to investigate the clinicopathologic features of patients with CBD stones and high aminotransferase levels.This prospective cohort study included 882 patients diagnosed with CBD stones using endoscopic retrograde cholangiopancreatography (ERCP)...
October 2016: Medicine (Baltimore)
D B Kadam, Sonali Salvi, Ajay Chandanwale
The World Health Organization (WHO) has coined the term expanded dengue to describe cases which do not fall into either dengue shock syndrome or dengue hemorrhagic fever. This has incorporated several atypical findings of dengue. Dengue virus has not been enlisted as a common etiological agent in several conditions like encephalitis, Guillain Barre syndrome. Moreover it is a great mimic of co-existing epidemics like Malaria, Chikungunya and Zika virus disease, which are also mosquito-borne diseases. The atypical manifestations noted in dengue can be mutisystemic and multifacetal...
July 2016: Journal of the Association of Physicians of India
Lotte Schut, Arnlaug Wangensteen, Jolanda Maaskant, Johannes L Tol, Roald Bahr, Maarten Moen
BACKGROUND: The current literature on the value of clinical evaluation for predicting time to return to sport (RTS) after acute hamstring injuries has not been systematically summarised. OBJECTIVES: The aim of this study was to systematically review the literature on the prognostic value of clinical findings (patient history and physical examination) for time to RTS after acute hamstring injuries in athletes. DATA SOURCES: The databases PubMed, EMBASE, SPORTDiscus and Cochrane Library were searched between October 2014 and August 2015...
October 18, 2016: Sports Medicine
Ji Yeon Lim, Yoon Hee Choi, Sun Hwa Lee
Epigastric pain is a common symptom in the emergency department. Most epigastric pain is not fatal, except in acute myocardial infarction, aortic dissection, and abdominal aneurysm rupture. Epigastric pain can also be the only symptom of isolated spontaneous gastric artery dissection. We report the case of a 51-year-old woman diagnosed with neurofibromatosis who initially presented with only epigastric pain. She was initially misdiagnosed with gastritis, treated conservatively, and discharged. Two hours later, she returned to the emergency department with persistent epigastric pain and rebound tenderness in the epigastric area...
June 2016: Clin Exp Emerg Med
Paul R Lambert, John Carey, Anthony A Mikulec, Carl LeBel
OBJECTIVE: To evaluate safety and efficacy of a single intratympanic injection of OTO-104, sustained-exposure dexamethasone, in patients with unilateral Ménière's disease. STUDY DESIGN: Randomized, double-blind, placebo-controlled, Phase 2b study over 5 months. SETTING: Fifty-two academic and community otolaryngology centers. PATIENTS: One hundred fifty four patients (77 per group) aged 18 to 85 years inclusive. INTERVENTION: Single intratympanic injection of OTO-104 (12 mg dexamethasone) or placebo...
September 30, 2016: Otology & Neurotology
Ronald J Maggiore, Kathryn E Callahan, Janet A Tooze, Ira R Parker, Tina Hsu, Heidi D Klepin
The number of older adults with cancer is growing, necessitating more collaborative training in both geriatric principles and cancer care. We administered a web-based survey to U.S. geriatrics program directors (PDs) addressing cancer-specific training and perspectives on optimal training content and roles for geriatricians in cancer care. Of 140 PDs contacted, 67 (48%) responded. Topics considered very important in training included cancer screening (79%) and cancer-related pain management (70%). Respondents strongly agreed that some of the geriatrician's roles in cancer care included assessing functional status (64%) and assessing physical/cognitive function for goals of care (64%)...
October 17, 2016: Gerontology & Geriatrics Education
Kazuki Takaoka, Emi Segawa, Michiyo Yamamura, Yusuke Zushi, Masahiro Urade, Hiromitsu Kishimoto
Dental implants play an important role in postoperative rehabilitation after surgical treatment of oral cancer through the provision of prosthetic tooth replacement. Two major implant prosthesis designs are available: fixed implant-supported prostheses and implant-supported overdentures. We herein report a case of a 16-year-old female patient who underwent alveolar ridge resection for treatment of mandibular gingival carcinoma. Following surgery, oral rehabilitation was attempted using an implant-supported overdenture on a gold bar retainer splinting four implants...
December 2015: Int J Implant Dent
Santiago Fabián Moscoso Martínez, Vadim Zarubin, Geethapriya Rajasekaran Rathnakumar, Alireza Zarineh
Smooth muscle tumors (SMTs) of the pleura are exceptionally rare. At present and to the best of these authors' knowledge, there are only 17 cases reported in the literature. We describe a case of a 51-year-old woman who complained of left sided pleuritic chest pain. Further, computed tomography (CT) revealed a left sided localized pleural-based mass involving the 9th rib. She underwent an interventional radiology guided percutaneous core biopsy of the lesion, which disclosed a "Smooth Muscle Tumor of Undetermined Malignant Potential (SMT-UMP)...
2016: Case Reports in Oncological Medicine
Guislaine Refregier, Edgar Abadia, Tomoshige Matsumoto, Hiromi Ano, Tetsuya Takashima, Izuo Tsuyuguchi, Elif Aktas, Füsun Cömert, Michel Kireopori Gomgnimbou, Stefan Panaiotov, Jody Phelan, Francesc Coll, Ruth Mcnerney, Arnab Pain, Taane G Clark, Christophe Sola
Two geographically distant M. tuberculosis sublineages, Tur from Turkey and T3-Osaka from Japan, exhibit partially identical genotypic signatures (identical 12-loci MIRU-VNTR profiles, distinct spoligotyping patterns). We investigated T3-Osaka and Tur sublineages characteristics and potential genetic relatedness, first using MIRU-VNTR locus analysis on 21 and 25 samples of each sublineage respectively, and second comparing Whole Genome Sequences of 8 new samples to public data from 45 samples uncovering human tuberculosis diversity...
October 13, 2016: Infection, Genetics and Evolution
Tonje A Sande, Barry J A Laird, Marie T Fallon
PURPOSE: Opioids are recommended for moderate to severe cancer pain; however, in patients with cancer, impaired renal function can affect opioid metabolism. The aim of this systematic review was to evaluate the current evidence for the use of opioids in cancer patients with renal impairment. METHODS: A systematic review was conducted and the following databases were searched: MEDLINE (1966 to 2015), EMBASE (1980 2015) and Cochrane Central Register of Controlled Trials (up to 2015)...
October 15, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
R S G M Perez
Pain is a multidimensional, subjective phenomenon that can only be understood within the context of an individual operating in a specific environment. As a consequence, it is difficult from an objective standpoint to satisfy the established criteria for classification. In general, it is the case that available classification systems can only partially capture pain in all of its complexity. There are various general and specific classification systems. In 2017, the International Classification of Diseases will be complemented with classification possibilities related to chronic pain...
October 2016: Nederlands Tijdschrift Voor Tandheelkunde
Alice Ashouri Christiansen, Oliver Hendricks, Dorota Kuettel, Kim Hørslev-Petersen, Anne Grethe Jurik, Steen Nielsen, Kaspar Rufibach, Anne Gitte Loft, Susanne Juhl Pedersen, Louise Thuesen Hermansen, Mikkel Østergaard, Bodil Arnbak, Claus Manniche, Ulrich Weber
OBJECTIVE: To determine the reproducibility of evaluation of sacroiliac joint (SIJ) radiographs among readers with varying levels of experience, and to identify potential drivers of disagreement in classification among 5 predefined radiographic lesion types. METHODS: The study sample consisted of 104 consecutive patients aged 18-40 with low back pain ≥ 3 months of duration who met the Assessment of SpondyloArthritis international Society (ASAS) definition for a positive SIJ magnetic resonance imaging, or were HLA-B27-positive and had ≥ 1 spondyloarthritis (SpA)-related clinical/laboratory feature according to the ASAS classification criteria for axial SpA...
October 15, 2016: Journal of Rheumatology
Mark McInturff, Anne Adamson, Chadwick Donaldson, Brenda L Nelson
A 19 year old female presents to the emergency room with right facial enlargement. Clinical examination revealed a soft tissue mass of the right buccal mucosa. Treated initially as infection, the patient later turned to clinic with now rapidly enlarging and intermittently painful mass. Computed tomography with contrast showed a low attenuated buccal mass with mild enhancement lateral to the right caudal maxilla and superior mandible. Biopsy was performed and microscopic examination showed cells with moderate pleomorphism with numerous atypical mitotic figures and occasional elongated "strap" cells with eccentric nuclei...
October 14, 2016: Head and Neck Pathology
Jianlei Zheng, Jingyang Lin, Naiji Shen, Baiming Qu
BACKGROUND: It is well known that cardiologists empirically judge the culprit lesion of acute ST-segment elevation myocardial infarction (STEMI) according to the corresponding electrocardiographic leads. However, In addition to the obstruction of left anterior descending (LAD) coronary artery, rare cases with the occlusion of proximal right coronary artery (RCA) and/or isolated right ventricular (RV) branch showed the ST-segment elevation in precordial leads V1-V3 as well. CASE SUMMARY: We reported a patient complaining of acute chest pain and suffering ventricular fibrillation (VF) on admission...
October 2016: Medicine (Baltimore)
Maria Jenelyn M Alviar, Tom Hale, Monalisa Dungca
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 12, 2011. Phantom limb pain (PLP) is pain that arises in the missing limb after amputation and can be severe, intractable, and disabling. Various medications have been studied in the treatment of phantom pain. There is currently uncertainty in the optimal pharmacologic management of PLP. OBJECTIVES: This review aimed to summarise the evidence of effectiveness of pharmacologic interventions in treating PLP...
October 14, 2016: Cochrane Database of Systematic Reviews
Verena Plodeck, Ulrich Sommer, Gustavo B Baretton, Daniela E Aust, Michael Laniado, Ralf-Thorsten Hoffmann, Ivan Platzek
Pancreatic endometriosis is very rare with only a few cases reported in the literature. The imaging features are non-specific and the definitive diagnosis is usually only established after surgery. We report on a 68-year-old woman with left upper quadrant pain who demonstrated a mass in the pancreatic tail on imaging. Laboratory results showed only mildly elevated liver enzymes, tumor markers were within the normal range. A left pancreatectomy was performed, frozen section suggesting a benign lesion, and final histopathology confirmed endometriotic cysts...
September 2016: Acta Radiologica Open
Osmar A Cuoghi, Francielle Topolski, Lorraine P de Faria, Marcos R de Mendonça
AIM: To evaluate the correlation between pain and tissue damage in response to orthodontic tooth movement (OTM), such as hyalinization and external apical root resorption (EARR). MATERIALS AND METHODS: The literature review was used as a methodological strategy, following the knowledge development process - constructivist (ProKnow-C). Study axes were defined and keywords that best represented each axis were selected. The terms were submitted to an adherence test and validation, resulting in 12 keyword combinations...
September 1, 2016: Journal of Contemporary Dental Practice
Maria Claudia Rodríguez, Perla Villamor, Tatiana Castillo
INTRODUCTION: Pain is a disease by itself and it's a public health concern of major implication in children, not just because of the emotional component of the child and his family, but also due to the potential morbidity and mortality involving it. A proper assessment of pain it's a challenge in the pediatric population, due to their lack of understanding and verbalization of hurt. Additionally, a satisfactory treatment of pediatric pain can be arduous due to a lack of clinical knowledge, insufficient pediatric research, and the fear to opioid side effects and addiction...
November 2016: International Journal of Pediatric Otorhinolaryngology
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