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Emergency pain management

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https://www.readbyqxmd.com/read/28318981/idiopathic-intradural-dorsal-thoracic-arachnoid-cysts-a-case-series-and-review-of-the-literature
#1
Heath French, Arjuna Somasundaram, Michael Biggs, Jonathon Parkinson, Rodney Allan, Jonathon Ball, Nicholas Little
BACKGROUND: Spinal intradural arachnoid cysts (SIAC) are cerebrospinal fluid (CSF) filled sacs formed by arachnoid membranes and may be either idiopathic or acquired. Idiopathic cysts represent a separate entity and their aetiology remains uncertain. By far the most difficult differential diagnosis is distinguishing between idiopathic anterior spinal cord herniation (IASCH) and dorsal thoracic intradural arachnoid cysts (TIAC), due to their similarity in radiological appearance. Cine-mode (SSFP) is emerging as a novel technique in the diagnosis and operative planning of SIAC...
March 17, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28317617/companion-animal-owner-perceptions-knowledge-and-beliefs-regarding-pain-management-in-end-of-life-care
#2
Roschelle Heuberger, Michael Petty, Janice Huntingford
The senior companion animal is the fastest growing segment of the pet population. End-of-life care, quality of life, and pain management (PM) are extremely important to pet owners. Research into PM and end-of-life care is essential due to lack of information on owner knowledge, attitudes, and beliefs. A survey was developed to gather information from owners. Surveys were developed using expert focus groups, and participants were recruited through social media. Survey validation employed emergent themes and grounded theory...
December 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28314949/tolerance-and-cross-tolerance-to-the-antinociceptive-effects-of-oxycodone-and-the-imidazoline-i2-receptor-agonist-phenyzoline-in-adult-male-rats
#3
David A Thorn, Yanan Zhang, Jun-Xu Li
RATIONALE: Emerging evidence suggests the potential utility of combining opioids with imidazoline I2 receptor agonists for chronic pain. However, chronic pain management requires prolonged pharmacotherapy, and the consequence of such combination therapy remains unclear. OBJECTIVE: This study examined the anti-hyperalgesic effect of the opioid oxycodone, the selective I2 receptor agonist phenyzoline, alone and in combination, during prolonged treatment. METHODS: Von Frey filament test was used to examine the anti-hyperalgesic effect of drugs in complete Freund's adjuvant (CFA)-induced inflammatory pain or chronic constriction injury (CCI)-induced neuropathic pain in rats...
March 17, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28303297/acute-calcific-tendinopathy-of-the-popliteus-tendon-a-rare-case-diagnosed-using-a-multimodality-imaging-approach-and-treated-conservatively
#4
Cédric Doucet, Akshat Gotra, Santhosh Mauvva Venkatesh Reddy, Mathieu Boily
Acute calcific tendinopathy of the popliteus tendon is a rare medical entity associated with significant patient discomfort. We present the case of a previously healthy 48-year-old female who presented to the emergency department with acute onset of left knee pain. Initial radiographs revealed calcifications within the posterolateral compartment of the knee. Ultrasound imaging demonstrated a swollen and hypoechoic popliteus tendon with an increased color Doppler signal at the periphery of the tendon as well as calcification in the tendon and adjacent soft tissues...
March 16, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28302660/rhabdomyolysis-induced-compartment-syndrome-secondary-to-atorvastatin-and-strenuous-exercise
#5
Louise Dunphy, Rossel Morhij, Sarah Tucker
A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3 days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5 mg once daily and atorvastatin 20 mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28302233/an-unusual-case-of-caecal-volvulus-due-to-appendicitis-successfully-managed-by-caecopexy
#6
Samiullah Bhatti, Mahmood Ayyaz Khan, Waris Farooka, Usman Ismat Butt, Usman Ali Rehman, Awais Amjad Malik
Caecal volvulus is a rare cause of intestinal obstruction. Caecal volvulus precipitated by acute appendicitis is even rarer. We report an unusual case of caecal volvulus with acute appendicitis as a cause. A 55-year female presented in surgical emergency with 3 days history of abdominal pain, distension and absolute constipation; and 2 days history of vomiting. Her past surgical history was significant for hysterectomy 5 years back. On examination, abdomen was distended and bowel sounds exaggerated. X-ray abdomen erect showed a single large air fluid level in the right hemiabdomen...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28299300/the-health-seeking-behaviors-and-perceptions-of-iranian-patient-with-osteoarthritis-about-pain-management-a-qualitative-study
#7
Vahid Zamanzadeh, Fazlollah Ahmadi, Marjaneh Foolady, Mozhgan Behshid, Alireza Irajpoor
Introduction: Pain is the main reason for patients with osteoarthritis (OA) to visit health clinics. Health seeking behaviors indicate unmet patient needs and lack of understanding of OA pain patterns. This study aimed to describe the experiences of Iranian patients with OA and explore their health seeking behaviors and perceptions on pain management related to osteoarthritis. Methods: Using a qualitative approach, data was collected by interviewing 19 patients, 2 family members, and 5 health care providers from the in-patient and out-patient clinics, and physicians' offices...
March 2017: Journal of Caring Sciences
https://www.readbyqxmd.com/read/28299231/chronic-osteoporotic-pain-in-mice-cutaneous-and-deep-musculoskeletal-pain-are-partially-independent-of-bone-resorption-and-differentially-sensitive-to-pharmacological-interventions
#8
Miyako Suzuki, Magali Millecamps, Lina Naso, Seiji Ohtori, Chisato Mori, Laura S Stone
Although the pathological changes in osteoporotic bones are well established, the characterization of the osteoporotic pain and its appropriate treatment are not fully elucidated. We investigated the behavioral signs of cutaneous and deep musculoskeletal pain and physical function; time-dependent changes in bone mineral density (BMD) and the emergence of the behavioral phenotype; and the effects of pharmacological interventions having different mechanisms of action (chronic intraperitoneal administration of pamidronate [0...
2017: Journal of Osteoporosis
https://www.readbyqxmd.com/read/28294095/the-simple-query-do-you-want-more-pain-medication-is-not-a-reliable-way-to-assess-acute-pain-relief-in-patients-in-the-emergency-department
#9
Jean-Marc Chauny, Martin Marquis, Jean Paquet, Gilles Lavigne, Alexis Cournoyer, Christiane Manzini, Raoul Daoust
OBJECTIVE: The management of acute pain constitutes an essential skill of emergency department (ED) physicians. However, the accurate assessment of pain intensity and relief represents a clinically challenging undertaking. Some studies have proposed to define effective pain relief as the patient's refusal for additional analgesic administration. The aim of this study was to verify whether such a refusal is effectively indicative of pain relief. METHODS: This prospective cohort study included ED patients who received single or multiple doses of pain medication for an acute pain problem...
March 15, 2017: CJEM
https://www.readbyqxmd.com/read/28290145/successful-surgical-intervention-for-rectal-perforation-due-to-polyarteritis-nodosa-report-of-a-case
#10
Keiji Yoshiya, Yu Imamura, Yu Nakaji, Daisuke Taniguchi, Rinne Takeda, Koji Ando, Yuichiro Nakashima, Motohiro Shimizu, Kippei Ohgaki, Norihiro Furusyo, Takuya Matsumoto, Hiroshi Saeki, Yoshinao Oda, Eiji Oki, Yoshihiko Maehara
BACKGROUND: Polyarteritis nodosa (PAN) is a primary systemic necrotizing vasculitis with diffuse organ involvements, resulting in a high mortality rate due to multiple organ failure. Although the small bowel is the frequently targeted organ of PAN-associated vasculitis, rectal involvement is very rare, and only one case of rectal bleeding has been previously reported. The mortality rate of PAN with gastrointestinal (GI) perforation is reportedly much higher than that of without severe GI involvement...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28286861/nerve-stimulator-versus-ultrasound-guided-femoral-nerve-block-a-randomized-clinical-trial
#11
Arash Forouzan, Kambiz Masoumi, Hasan Motamed, Mohammad Reza Gousheh, Akram Rohani
INTRODUCTION: Pain control is the most important issue in emergency department management of patients with femoral bone fractures. The present study aimed to compare the procedural features of ultrasonography and nerve stimulator guided femoral nerve block in this regard. METHOD: In this randomized clinical trial, patients with proximal femoral fractures presenting to emergency department were randomly divided into two groups of ultrasonography or nerve stimulator guided femoral block and compared regarding success rate, procedural time, block time, and need for rescue doses of morphine sulfate, using SPSS 20...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286819/pain-management-via-ultrasound-guided-nerve-block-in-emergency-department-a-case-series-study
#12
Amir Nejati, Houman Teymourian, Leili Behrooz, Gholamreza Mohseni
INTRODUCTION: Pain is the most common complaint of patients referring to emergency department (ED). Considering the importance of pain management in ED, this study aimed to investigate the efficacy and feasibility of ultrasound-guided nerve blocks in this setting. METHODS: 46 patients who came to the ED with injured extremities were enrolled in the study and received either femoral, axillary or sciatic nerve block depending on their site of injury (1.5 mg Bupivacaine per kg of patient's weight)...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286809/ketorolac-versus-magnesium-sulfate-in-migraine-headache-pain-management-a-preliminary-study
#13
Hossein Delavar Kasmaei, Marzieh Amiri, Ahmed Negida, Samaneh Hajimollarabi, Nastaransadat Mahdavi
INTRODUCTION: Migraine is a common cause of emergency department (ED) visits. To date, there is no recommended drug of choice for pain management of these patients. In the present study, we aimed to evaluate the effectiveness of ketorolac and magnesium sulfate in this regard. METHODS: This is a cross-sectional study performed on all 18 - 60 year-old patients, visiting two different EDs with complaint of moderate to severe migraine headache. Patients were treated with 30 mg ketorolac in one hospital and 1 gram magnesium sulfate in the other...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285863/low-dose-ketamine-use-in-the-emergency-department-a-new-direction-in-pain-management
#14
A Pourmand, M Mazer-Amirshahi, C Royall, R Alhawas, R Shesser
There is a need for alternative non-opioid analgesics for the treatment of acute, chronic, and refractory pain in the emergency department (ED). Ketamine is a fast acting N-methyl-d-aspartate (NMDA) receptor antagonist that provides safe and effective analgesia. The use of low dose ketamine (LDK) (<1mg/kg) provides sub-dissociative levels of analgesia and has been studied as an alternative and/or adjunct to opioid analgesics. We reviewed 11 studies using LDK either alone or in combination with opioid analgesics in the ED...
March 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28282364/lung-ultrasound-for-the-regional-anesthesiologist-and-acute-pain-specialist
#15
Stephen C Haskins, Ban C Tsui, Jemiel A Nejim, Christopher L Wu, Jan Boublik
In this article, we discuss the emerging role of lung point-of-care ultrasonography for regional anesthesiologists and pain management specialists. Lung ultrasonography is a well-established clinical tool that is used on a routine basis in emergency rooms and critical care units internationally to evaluate patients with respiratory distress; however, its benefits to the regional anesthesiologist and pain specialist are not as well known and are practiced less frequently. This review article covers the clinical evidence in support of lung point-of-care ultrasonography as a rapid and superior tool to traditional imaging modalities such as chest radiography and fluoroscopy...
March 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28281433/a-randomised-trial-comparing-laparoscopy-with-laparotomy-in-the-management-of-women-with-ruptured-ectopic-pregnancy
#16
L Snyman, T Makulana, J D Makin
BACKGROUND: Ruptured ectopic pregnancy (REP) is a common gynaecological emergency in resource-poor settings, where laparotomy is the standard treatment despite laparoscopic surgery being regarded as the optimal treatment. There is a lack of prospective randomised data comparing laparoscopic surgery with laparotomy in the surgical management of women with REP. OBJECTIVE: To compare operative laparoscopy with laparotomy in women with REP. METHODS: This was a randomised parallel study...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28281431/the-accuracy-of-nurse-performance-of-the-triage-process-in-a-tertiary-hospital-emergency-department-in-gauteng-province-south-africa
#17
L N Goldstein, L M Morrow, T A Sallie, K Gathoo, K Alli, T M M Mothopeng, F Samodien
BACKGROUND: Triage in the emergency department (ED) is necessary to prioritise management according to the severity of a patient's condition.The South African Triage Scale (SATS) is a hospital-based triage tool that has been adopted by numerous EDs countrywide.Many factors can influence the outcome of a patient's triage result, and evaluation of performance is therefore pivotal. OBJECTIVES: To determine how often patients were allocated to the correct triage category and the extent to which they were incorrectly promoted or demoted, and to determine the main reasons for errors in a nurse-led triage system...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28280980/emergencies-in-motoneuron-disease
#18
REVIEW
Josef Finsterer, Claudia Stöllberger
Genetic and acquired motor-neuron-disorders (MNDs) may undergo acute deterioration resulting in various emergency situations. This literature review aims at summarising and discussing current knowledge about emergencies in MNDs. Emergencies that have been reported in MND patients include: respiratory, bulbar, cardiac, septic, epileptic, psychiatric, pain-related, and traumatic emergencies. Emergencies due to respiratory insufficiency have the strongest impact on morbidity and mortality in MNDs. To optimise the management of emergencies in MNDs, it is recommended to discuss these topics with the patient prior to their occurrence...
March 9, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28279592/older-red-cell-units-are-associated-with-an-increased-incidence-of-infection-in-chronically-transfused-adults-with-sickle-cell-disease
#19
Matthew S Karafin, Erica Carpenter, Amy Pan, Pippa Simpson, Joshua J Field
BACKGROUND: In adults with sickle cell disease (SCD), the effects of the red cell storage lesion are not well defined. The objectives of this study were to: (1) describe the distribution of storage ages provided to adults with SCD, and (2) evaluate clinical outcomes associated with storage age. PATIENTS AND METHODS: We performed a retrospective cohort study of adults with SCD managed with prophylactic simple transfusion regimens. Units were universally pre-storage leukocyte reduced and CEK-matched...
February 9, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28279542/the-use-of-ketamine-for-acute-treatment-of-pain-a-randomized-double-blind-placebo-controlled-trial
#20
Billy Sin, Tamara Tatunchak, Mohammad Paryavi, Maria Olivo, Usman Mian, Josel Ruiz, Bupendra Shah, Sylvie de Souza
BACKGROUND: Pain is one of the most common reasons for emergency department (ED) visits in the United States. Ketamine is a sedative with N-methyl-D-aspartate (NMDA) receptor antagonism. Recent literature has suggested that the use of subdissociative dose ketamine (SDDK) may be safe and effective for acute pain. OBJECTIVE: The objective of our study was to evaluate ketamine in subdissociative doses as an adjunct for acute pain in the ED. METHODS: This was a single-center, prospective, randomized, double-blind, placebo-controlled trial that evaluated the use of SDDK in adult patients who presented to the ED with acute pain...
March 6, 2017: Journal of Emergency Medicine
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