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https://www.readbyqxmd.com/read/28938508/-angina-pectoris-in-a-young-woman-with-lupus-erythematosus
#1
Simon Braumann, Malte P Bartram, Roman Pfister, Guido Michels
History and clinical findings We present a 31-year old woman with a 6-year history of cutaneous lupus erythematosus (CLE) who presented to the emergency room with typical chest pain. ECG and transthoracic echocardiography were normal. Her working diagnosis of pericarditis was made due to systemic progression of her lupus erythematosus (LE). Treatment with NSAIDs was initiated and her immunosuppressive regimen intensified. The patient was discharged after resolution of her symptoms. A week later, the patient was seen at the rheumatology clinic with recurrence and aggravation of her symptoms...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28937443/reducing-disability-durations-and-medical-costs-for-patients-with-a-carpal-tunnel-release-surgery-through-the-use-of-opioid-prescribing-guidelines
#2
Fraser W Gaspar, Roman Kownacki, Catherine S Zaidel, Craig F Conlon, Kurt T Hegmann
OBJECTIVE: The impacts of compliance with opioid prescribing guidelines on disability durations and medical costs for carpal tunnel release (CTR) were examined. METHODS: Using a dataset of insured US employees, opioid prescriptions for 7840 short-term disability cases with a CTR procedure were identified. Opioids prescriptions were compared with the American College of Occupational and Environmental Medicine (ACOEM)'s opioid prescribing guidelines for postoperative, acute pain, which recommends no more than a 5-day supply, a maximum morphine equivalent dose of 50 mg/day, and only short-acting opioids...
September 20, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28936554/preoperative-flurbiprofen-axetil-administration-for-acute-postoperative-pain-a-meta-analysis-of-randomized-controlled-trials
#3
Ke Wang, Jun Luo, Limin Zheng, Tao Luo
OBJECTIVE: Non-steroidal anti-inflammatory drugs have been shown to effectively decrease postoperative pain and reduce opioid requirements. Flurbiprofen axetil is an injectable non-selective cyclooxygenase inhibitor that has a high affinity for inflammatory tissues to achieve targeted drug therapy and prolonged duration of action. This meta-analysis examined the use of preoperative flurbiprofen axetil and its impact on postoperative analgesia. METHODS: An electronic literature search of the Library of PubMed, Cochrane CENTRAL, and EMBASE databases was conducted in Feb 2016...
September 21, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28932913/a-prospective-randomized-controlled-trial-evaluating-the-short-term-outcomes-of-transanal-hemorrhoidal-dearterialization-versus-tissue-selecting-technique
#4
A L H Leung, T P P Cheung, K Tung, Y P Tsang, H Cheung, C W Lau, C N Tang
BACKGROUND: Tissue-selecting technique (TST) is a novel stapled hemorrhoidectomy technique which targets the hemorrhoids, leaving uninvolved mucosal bridges intact and avoiding circumferential circular stapling. The aim of this study was to compare the short-term outcomes of TST and transanal hemorrhoidal dearterialization (THD). METHODS: Patients presenting with symptomatic hemorrhoids were recruited. Patients were randomized into two groups: (1) TST and (2) THD...
September 20, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28932352/novel-technique-of-abdominal-wall-nerve-block-for-laparoscopic-colostomy-rectus-sheath-block-with-transperitoneal-approach
#5
Jun Nagata, Jun Watanabe, Yusuke Sawatsubashi, Masaki Akiyama, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Kotaro Hamada, Yoshifumi Nakayama, Keiji Hirata
A 62-year-old man who had acute rectal obstruction due to a large rectal cancer is presented. He underwent emergency laparoscopic colostomy. We used the laparoscopic puncture needle to inject analgesia with the novel transperitoneal approach. In this procedure, both ultrasound and laparoscopic images assisted with the accurate injection of analgesic to the correct layer. The combination of laparoscopic visualization and ultrasound imaging ensured infiltration of analgesic into the correct layer without causing damage to the bowel...
August 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28928577/a-prospective-observational-study-to-evaluate-the-role-of-gabapentin-as-preventive-analgesic-in-thyroidectomy-under-general-anesthesia
#6
Vadakkoot Raghavan Hema, Konnanath Thekkethil Ramadas, Kannammadathy Poulose Biji, Suseela Indu, Aravind Arun
BACKGROUND: Effective management of postoperative pain is a part of well-organized perioperative care, which helps in reduced morbidity and improved patient satisfaction. Preventive analgesia can reduce acute and chronic pain by blocking the noxious inputs to pain pathways, preventing sensitization. Studies have reported efficacy of gabapentin as a preventive analgesic in perioperative pain. In this study, we aimed to determine whether preoperative gabapentin reduced postoperative pain and tramadol consumption after thyroidectomy under general anesthesia...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28925927/postoperative-endophthalmitis-caused-by-bosea-thiooxidans
#7
Vaidehi S Dedania, Devon H Ghodasra, David N Zacks
PURPOSE: To report an unusual case of postcataract endophthalmitis secondary to Bosea thiooxidans. METHODS: Case report. RESULTS: An 86-year-old man presented with postoperative endophthalmitis 3 weeks after uncomplicated cataract surgery. He complained of a headache and blurry vision but denied having eye pain. Slit-lamp examination demonstrated leukocytes with a fibrinous membrane in the anterior segment and vitritis. A diagnosis of acute postoperative endophthalmitis was made, and the patient was treated with intravitreal antibiotics...
October 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#8
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28913854/preoperative-ultraviolet-b-inflammation-in-skin-modelling-individual-differences-in-acute-postoperative-pain-and-neuro-immune-interactions
#9
T H Lunn, J M Dawes, F Denk, D L Bennett, H Husted, H Kehlet, S B McMahon
BACKGROUND: Neuroimmune interactions play a vital role in many of the most common pain conditions, such as arthritis. There have been many attempts to derive clinically predictive information from an individual's inflammatory response in order to gauge subsequent pain perception. OBJECTIVES: Here, we wanted to test whether this effort could be enhanced and complemented by the use of a model system which takes into account the function of not just circulating, but also tissue-resident immune cells: ultraviolet B (UVB) irradiation of the skin...
September 14, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28906391/a-meta-analysis-of-the-preoperative-use-of-gabapentinoids-for-the-treatment-of-acute-postoperative-pain-following-spinal-surgery
#10
REVIEW
Bo Liu, Ruihe Liu, Lifeng Wang
BACKGROUND: Gabapentinoid drugs, which include gabapentin and pregabalin, play an established role in the management of neuropathic pain. However, whether preoperative administration of gabapentinoids has a beneficial role in controlling acute pain after spinal surgery is unknown. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the efficacy and safety of the preoperative use of gabapentinoids (gabapentin and pregabalin) for the treatment of acute postoperative pain following spinal surgery...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906382/the-efficacy-of-gabapentin-in-reducing-pain-intensity-and-postoperative-nausea-and-vomiting-following-laparoscopic-cholecystectomy-a-meta-analysis
#11
Lifeng Wang, Yucai Dong, Jiling Zhang, Hongwu Tan
BACKGROUND: It is unknown whether gabapentin is effective in reducing acute pain following laparoscopic cholecystectomy. The purpose of the current meta-analysis was to evaluate the efficacy of gabapentin in reducing pain intensity and postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy. METHODS: All randomized controlled trials (RCTs) evaluating the efficacy of gabapentin in reducing pain intensity and PONV after laparoscopic cholecystectomy were searched on the following databases: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Google database, the Chinese Wanfang database, and the China National Knowledge Infrastructure (CNKI)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28904722/-normal-adnexal-torsion-and-pregnancy-about-a-case
#12
Ahmed Guennoun, Yousra Krimou, Nisrine Mamouni, Sanaa Errarhay, Chahrazed Bouchikhi, Abdelaziz Banani
Normal adnexal torsion is rare during pregnancy. We here report the case of a 22-year old patient presenting with acute lateropelvic pain associated with a 2-month history amenorrhea. Exploratory laparotomy showed severe ischemia due to torsion in a normal ovary. The patient underwent adnexal detorsion without ovarian pexy. The postoperative course was uneventful. Ultrasound examination after 3 weeks showed normal pregnancy. Ovarian torsion is an emergency that should not be ignored in pregnant women with acute pelvic pain...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28901811/the-efficacy-of-stretching-exercises-to-reduce-posterior-shoulder-tightness-acutely-in-the-postoperative-population-a-single-blinded-randomized-controlled-trial
#13
Paul A Salamh, Morey J Kolber, Eric J Hegedus, Chad E Cook
BACKGROUND: Posterior shoulder tightness (PST) is a postoperative complication leading to pain, impaired mobility, and reduced function. Despite the potential morbidity associated with PST, no studies have investigated the efficacy of shoulder-stretching methods in the postsurgical population. The purpose of this study was to determine the short-term efficacy of two stretches designed to reduce PST. METHODS: The study enrolled 63 patients [mean age 51 (12) years, height 173...
September 13, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28895017/total-pancreatectomy-with-islet-autotransplantation-for-acute-recurrent-and-chronic-pancreatitis
#14
REVIEW
Varvara A Kirchner, Ty B Dunn, Gregory J Beilman, Srinath Chinnakotla, Timothy L Pruett, Joshua J Wilhelm, Sarah J Schwarzenberg, Martin L Freeman, Melena D Bellin
PURPOSE OF REVIEW: The first total pancreatectomy and islet autotransplantation (TP-IAT) was performed for chronic pancreatitis in 1977 with the goal to ameliorate the pain and simultaneously preserve islet function. We reviewed the recent medical literature regarding indications, patient suitability, current outcomes, and challenges in TP-IAT. RECENT FINDINGS: Current indications for TP-IAT include intractable pain secondary to chronic pancreatitis (CP) or acute recurrent pancreatitis (ARP) with failed medical and endoscopic/surgical management...
September 11, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28893706/hypertension-acute-stent-thrombosis-and-paraplegia-6-months-after-tevar-for-blunt-thoracic-aortic-injury-in-a-22-year-old-patient
#15
O Martinelli, F Faccenna, A Malaj, J Jabbour, S Venosi, R Gattuso, B Gossetti, L Irace
TEVAR is a less invasive option for managing traumatic injuries of the descending aorta in polytraumatized patients. Concerns arise when treating young patients with TEVAR. A 22-year old male was admitted to the Emergency Department following a high-impact road traffic collision. Whole body CT scan documented multiple injuries, including rupture of descending thoracic aorta just below the isthmus. There was no evidence of paraplegia or stroke. We decided to treat him in an endovascular fashion with a Zenith Cook (Cook Incorporated, Bloomington, IN) endograft...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28882350/preoperative-norepinephrine-levels-in-cerebrospinal-fluid-and-plasma-correlate-with-pain-intensity-after-pediatric-spine-surgery
#16
Catherine E Ferland, Alexandre J Parent, Neil Saran, Pablo M Ingelmo, Anaïs Lacasse, Serge Marchand, Philippe Sarret, Jean A Ouellet
PURPOSE: Catecholamines were found to be involved in descending pain modulation and associated with perioperative pain. The purpose of the present study was to investigate the relationship between preoperative concentrations of catecholamines and postoperative pain intensity of pediatric patients. METHODS: Fifty adolescents with idiopathic scoliosis scheduled for elective spinal fusion surgery were enrolled in this prospective cohort study. Preoperative plasma and cerebrospinal fluid (CSF) samples were collected and analyzed by mass spectrometry...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28876686/management-of-failed-mitral-valve-replacement-the-durban-experience
#17
D Kistan, M Booysen, G Alexander, T E Madiba
BACKGROUND: Mitral valve replacement is the procedure of choice in patients with severe mitral valve disease. However, these patients are surviving longer and are thus at an increased risk of prosthesis failure or valve-related complications. METHOD: Study setting: Inkosi Albert Luthuli Central Hospital, a tertiary referral Hospital in Durban. Study population: All patients undergoing redo mechanical mitral valve replacement surgery between January 2005 and December 2014...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876572/haemoperitoneum-secondary-to-snake-bite
#18
S Rahim
BACKGROUND: Literature supports that very rarely the venom of "Hemotoxic Snake" (Russell's Vipers) affect haemostasis by secreting thrombin-like enzyme which promotes formation of unstable clots. Such clots could lead to fibrin deposition in micro circulation that in turn consume platelets and coagulation factors (consumption coagulopathy). Clinical presentation is mainly spontaneous bleeding and coagulopathy. In this case the significant effects of altered coagulation were observed in retropetitoneum and the patient presented in casuality as acute abdomen...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876423/thrombosed-aneurysm-of-saphenous-vein-coronary-artery-bypass-grafting
#19
Rodolfo Mendes Queiroz, Rogério Nastri, Marcus Antônio Ferez, Mauro José Brandão da Costa, Claudio Benedini Laguna, Marcus Vinicius Nascimento Valentin
We describe the case of a male patient, aged 76 years, referred for cardiac investigation due to retrosternal chest pain and dyspnea. He had a history of acute myocardial infarction and angioplasties in the last 30 years, including a saphenous vein coronary artery bypass grafting (SVCABG). Echocardiogram showed hypoechoic oval formation near the right ventricle, suggesting a pericardial cyst. Computed angiotomography revealed a predominantly fusiform and thrombosed aneurysmal dilation of the SVCABG to the right coronary artery...
June 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28870309/multimodal-analgesia-in-foot-and-ankle-surgery
#20
REVIEW
Jessica M Kohring, Nathan G Orgain
Progress in surgical acute pain management has allowed most foot and ankle surgery to be performed in ambulatory outpatient surgical centers. Multimodal analgesia focuses on improving postoperative pain by combining pharmacologic and other modalities, addressing multiple pain mechanisms and receptor pathways while reducing adverse effects through lower doses of oral medications. Local anesthesia techniques provide excellent pain relief with few adverse events. Multimodal analgesia in foot and ankle surgery provides superior pain relief, and reduced opioid dependence and opioid-related side effects, improving patient satisfaction, safety, and timely return to function...
October 2017: Orthopedic Clinics of North America
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