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Pain Trauma

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https://www.readbyqxmd.com/read/28938286/optimizing-bone-defect-reconstruction-balanced-cable-transport-with-circular-external-fixation
#1
Stephen Matthew Quinnan, Charles Lawrie
Distraction osteogenesis has proven effective in the management of tibial bone loss from severe trauma and infection. Unfortunately, pain and scarring from wires and half pins dragging through the skin and the required prolonged time in the external fixator make treatment difficult. Cable bone transport has been shown to improve cosmesis and decrease pain during transport. However, the published methods have limitations in that they have poor control of transport segment alignment, do not allow for lengthening of the limb, and do not permit weight bearing during the treatment process...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28937462/instability-in-thoracolumbar-trauma-is-a-new-definition-warranted
#2
Salman Abbasi Fard, Jesse Skoch, Mauricio J Avila, Apar S Patel, Kamran V Sattarov, Christina M Walter, Ali A Baaj
STUDY DESIGN: Review of the articles. OBJECTIVE: The objective of this study was to review all articles related to spinal instability to determine a consensus statement for a contemporary, practical definition applicable to thoracolumbar injuries. SUMMARY OF BACKGROUND DATA: Traumatic fractures of the thoracolumbar spine are common. These injuries can result in neurological deficits, disability, deformity, pain, and represent a great economic burden to society...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28935009/acute-occlusion-of-the-abdominal-aorta-with-sudden-paraplegia-in-a-captive-mustached-tamarin-saguinus-mystax
#3
Carmen R Michaud, Richard Herbert, William R Elkins, Alfonso S Gozalo
A wild-caught, research-naïve, adult male mustached tamarin (Saguinus mystax) experienced sudden onset of bilateral hindlimb paresis. Physical examination established the presence of paralysis and the lack of femoral pulses and deep pain in both legs. There were no signs of external trauma and, due to a poor prognosis, euthanasia was elected. Necropsy findings included pleural effusion, partial pulmonary atelectasis and congestion, dilatatory cardiomyopathy, a renal hemorrhagic infarct, and a thromboembolus located at the trifurcation of the distal abdominal aorta...
October 1, 2017: Comparative Medicine
https://www.readbyqxmd.com/read/28933699/pyoderma-gangrenosum-an-uncommon-case-report-and-review-of-the-literature
#4
António Carlos Lemos, Debora Aveiro, Natália Santos, Vítor Marques, Luís Filipe Pinheiro
BACKGROUND: Pyoderma gangrenosum (PG) is a rare ulcerative condition that is diagnostically and therapeutically challenging, as debridement leads to ulcer deterioration (pathergy phenomenon); immunosuppression is considered the gold standard therapy. CASE REPORT: The authors present the case of a 42-year-old woman with PG and uncontrolled iatrogenic diabetes, secondary to a total pancreatectomy performed in another hospital in 1998 due to nesidioblastosis. In 2008, she was referred to the diabetic foot consultation at Centro Hospitalar Tondela-Viseu (Viseu, Portugal) due to an infected wound on the left leg thought to be related to a trauma from footwear, but the injury worsened despite treatment...
September 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28931334/repeated-exposure-to-experimental-pain-differentiates-combat-tbi-with-and-without-ptsd
#5
Irina A Strigo, Andrea D Spadoni, Sabra S Inslicht, Alan N Simmons
Mild traumatic brain injury(mTBI) and posttraumatic stress disorder(PTSD) are highly comorbid conditions that often co-occur with chronic pain. We have shown that women with PTSD following intimate partner violence show attenuated brain response to repeated experimental pain that was related to symptoms of avoidance. The aim of this study was to extend our prior findings to males with combat trauma and to examine brain response to experimental pain in men with and without PTSD who sustained mTBI during combat...
September 20, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28930944/negative-ct-can-safely-rule-out-clinically-significant-intra-abdominal-injury-in-the-asymptomatic-patient-after-blunt-trauma-prospective-evaluation-of-1193-patients
#6
Elizabeth Benjamin, Jayun Cho, Gustavo Recinos, Evren Dilektasli, Lydia Lam, John Brunner, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Computed tomography of the abdomen and pelvis (CTAP) is highly specific for injury identification and commonly used in the evaluation of blunt trauma patients. Despite this, there is no consensus on the required clinical observation period after negative imaging, often impacting patient flow and hospital cost. The purpose of this study was to evaluate the use of CTAP after blunt trauma and the need for observation following negative imaging. METHODS: A prospective analysis at a large level I trauma center was conducted from 11/2014-5/2015...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28928589/laparoscopic-cholecystectomy-under-segmental-thoracic-spinal-anesthesia-a-feasible-economical-alternative
#7
Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal
Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml(-1) mixed with 0.5 ml of fentanyl 50 μg ml(-1). Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927908/the-impact-of-the-standard-american-diet-in-rats-effects-on-behavior-physiology-and-recovery-from-inflammatory-injury
#8
Stacie K Totsch, Tammie L Quinn, Larissa J Strath, Laura J McMeekin, Rita M Cowell, Barbara A Gower, Robert E Sorge
BACKGROUND AND AIMS: Obesity is a significant health concern in the Western world and the presence of comorbid conditions suggests an interaction. The overlapping distributions of chronic pain populations and obesity suggests that an interaction may exist. Poor quality diet (high carbohydrates, saturated fats, omega-6 polyunsaturated fatty acids) can lead to increased adiposity which can activate immune cells independent of the activating effect of the diet components themselves. This dual action can contribute to chronic inflammation that may alter susceptibility to chronic pain and prolong recovery from injury...
September 16, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28927578/the-critical-care-pain-observation-tool-is-reliable-in-non-agitated-but-not-in-agitated-intubated-patients
#9
Hoda Chookalayia, Mehdi Heidarzadeh, Mohammad Hassanpour-Darghah, Masoomeh Aghamohammadi-Kalkhoran, Mansoreh Karimollahi
OBJECTIVE: The Critical-Care Pain. OBSERVATION: Tool is one of the instruments developed to assess pain in patients who are unable to communicate verbally. The study aimed to survey the psychometric properties of Critical-Care Pain. OBSERVATION: Tool in four groups of non-verbal patients according to their Richmond Agitation Sedation Score (RASS). STUDY DESIGN AND METHODOLOGY: 65 critically ill patients (medical, surgical, trauma) were assessed using the critical care pain observation tool on six occasions (before, during and after nociceptive and non-nociceptive procedures)...
September 15, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28926849/-a-nationwide-survey-of-undergraduate-training-in-orthopaedics-and-trauma-surgery
#10
Miriam Ruesseler, Susanne Froehlich, Sigrid Ruesseler, Julian Zabel, Jasmina Sterz, Udo Obertacke
Background Musculoskeletal conditions are the most frequent cause of long-term pain and disability. Scientifically funded, structured training would be highly desirable for all medical students and of great economic relevance for the health care system. The present article portrays the status quo of undergraduate training in orthopaedics and trauma surgery, with a comparison to the status quo of 2008. Material and Methods A 51-item questionnaire was sent to all heads of the departments of orthopaedics or trauma surgery at the 37 medical faculties in Germany...
September 19, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#11
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28924315/comparison-between-continuous-thoracic-epidural-block-and-continuous-thoracic-paravertebral-block-in-the-management-of-thoracic-trauma
#12
Shalendra Singh, Mathews Jacob, S Hasnain, Mathangi Krishnakumar
BACKGROUND: Postoperative pain is thought to be the single most important factor leading to ineffective ventilation and impaired secretion clearance after thoracic trauma. Effective pain relief can be provided by thoracic epidural analgesia but may have side effects or contraindications. Paravertebral block is an effective alternative method without the side effects of a thoracic epidural. We did this study to compare efficacy of thoracic epidural and paravertebral block in providing analgesia to thoracic trauma patients...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28924000/nerf-gun-eye-injuries-traumatic-hyphema
#13
Mukhtar Bizrah, Seema Verma
Three unrelated patients attended the accident and emergency department with pain and blurred vision after ocular injury with a Nerf gun. Two were adults and one was a child, all of which presented within a 3 months' period. All three cases were found to have ≥1 mm of traumatic hyphema (pooling of blood in anterior chamber of the eye), indicating significant ocular trauma. The two adult patients had formed hyphema and uveitis. The 11-year-old child had formed hyphema, corneal oedema, anterior uveitis, localised angle recession and commotio retinae, which further highlight the severity of the ocular trauma...
September 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28923035/comparison-of-volar-flexion-ulnar-deviation-and-functional-position-cast-immobilization-in-the-non-operative-treatment-of-distal-radius-fracture-in-elderly-patients-a-pragmatic-randomized-controlled-trial-study-protocol
#14
Lauri Raittio, Antti Launonen, Teemu Hevonkorpi, Toni Luokkala, Juha Kukkonen, Aleksi Reito, Bakir Sumrein, Minna Laitinen, Ville M Mattila
BACKGROUND: Distal radius fractures (DRFs) are the second most common fractures, after hip fractures, seen in clinical practice. The high incidence of low-energy trauma DRFs in elderly patients raises questions about the best treatment method in terms of function, pain, and quality of life. Although the majority of these fractures are treated non-operatively with cast immobilization, valid scientific evidence of the optimal cast immobilization is lacking. In addition, several publications, including Cochrane review have outlined the need for more evidence to determine the most appropriate method of cast immobilization...
September 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28922053/distribution-and-function-of-voltage-gated-sodium-channels-in-the-nervous-system
#15
Jun Wang, Shao-Wu Ou, Yun-Jie Wang
Voltage-gated sodium channels (VGSCs) are the basic ion channels for neuronal excitability, which are crucial for the resting potential and the generation and propagation of action potentials in neurons. To date, at least nine distinct sodium channel isoforms have been detected in the nervous system. Recent studies have identified that voltage-gated sodium channels not only play an essential role in the normal electrophysiological activities of neurons but also have a close relationship with neurological diseases...
September 18, 2017: Channels
https://www.readbyqxmd.com/read/28921731/inter-observer-agreement-in-pediatric-cervical-spine-injury-assessment-between-prehospital-and-emergency-department-providers
#16
Lorin R Browne, Hamilton Schwartz, Fahd A Ahmad, Michael Wallendorf, Nathan Kuppermann, E Brooke Lerner, Julie C Leonard
BACKGROUND: Investigators have derived cervical spine injury (CSI) decision support tools from physician observations. There is a need to demonstrate that prehospital emergency medical services (EMS) providers can use these tools to appropriately determine the need for spinal motion restrictions and make field disposition decisions. OBJECTIVE: To determine the inter-observer agreement between EMS and emergency department (ED) providers for CSI risk assessment variables and overall gestalt for CSI in children after blunt trauma...
September 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28920163/correction-of-whistle-deformity-using-autologous-free-fat-grafting-first-results-of-a-pilot-study-and-review-of-the-literature
#17
Sven Holger Baum, Gunnar Rieger, Roman Pförtner, Christopher Mohr
PURPOSE: Whistle deformities are frequent sequelae after surgical correction of cleft lip, trauma, or tumor excision. The aim of this study was to examine the role of autologous free fat grafting in the reconstruction of whistle deformity. PATIENTS: Fifteen patients with whistle deformity were enrolled in this pilot study. The mean follow-up period was 19 months. Liposuction was done followed by the replantation of an average of 2.2 ml autologous fat per patient (range 0...
September 17, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28920036/hematoma-block-versus-general-anesthesia-in-distal-radius-fractures-in-patients-over-60-years-in-trauma-emergency
#18
Ali Tabrizi, Fardin Mirza Tolouei, Ebrahim Hassani, Hassan Taleb, Asghar Elmi
BACKGROUND: Distal radius fractures are among common fractures in the elderly. Regarding the age, background diseases, and possible risks, analgesia method is of great importance in this group. OBJECTIVES: The aim of this study was to compare two analgesia methods including hematoma block and general anesthesia in people over 60 years in the orthopedic emergency department. METHODS: 68 elderly patients referring to the emergency department of a medical teaching center were selected based on the inclusion criteria for a non-randomized clinical trial...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#19
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28915155/social-support-and-pain-outcomes-after-trauma-exposure-among-older-adults-a-multicenter-longitudinal-study
#20
Natalie L Richmond, Michelle L Meyer, Allison G Hollowell, Erin E Isenberg, Robert M Domeier, Robert A Swor, Phyllis L Hendry, David A Peak, Niels K Rathlev, Jeffrey S Jones, David C Lee, Christopher W Jones, Timothy F Platts-Mills
OBJECTIVES: Certain forms of social support have been shown to improve pain coping behaviors and pain outcomes in older adults with chronic pain, but little is known about the effect of social support on pain outcomes in older adults following trauma exposure. METHODS: We analyzed data from a prospective longitudinal study of adults aged 65 years and older presenting to an emergency department (ED) after a motor vehicle collision (MVC) to characterize the relationship between perceived social support and MVC-related pain after trauma overall and by subgroups based on gender, depressive symptoms, and marital status...
September 14, 2017: Clinical Journal of Pain
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