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https://www.readbyqxmd.com/read/27931558/time-to-shift-from-contemporary-to-high-sensitivity-cardiac-troponin-in-diagnosis-of-acute-coronary-syndromes
#1
REVIEW
Jamshed J Dalal, C K Ponde, Brian Pinto, C N Srinivas, Joy Thomas, Sunil Kumar Modi, Sanjay Mehta, Suvin Shetty, Manimarane, Bhupen Desai
Early rule-in and rule-out of non-ST-segment elevation myocardial infarction (NSTEMI) is a challenge. In patients with inconclusive findings on ECG, cardiac biomarkers play a crucial role in the diagnosis. The introduction of the new high-sensitive cardiac troponin test (hs-TnI assay) has changed the landscape of NSTEMI diagnosis. The new hs-TnI assay can detect troponin values at a lower level compared with a contemporary cardiac troponin (cTn) assay. The hs-cTnI assay has a coefficient of variation of ≤10%, well below the 99th percentile value...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27930855/diagnosis-and-management-of-ovarian-vein-thrombosis-in-a-healthy-individual-a-case-report-and-a-literature-review
#2
Namratha Kodali, Irina Veytsman, Sabrina Martyr, Kit Lu
Ovarian vein thrombosis (OVT) is a rare condition most often seen in the immediate post-partum period. We report a 40-year-old woman with no significant past medical or surgical history who presented to the emergency room for acute right lower quadrant pain of one day duration. A computed tomography (CT) scan showed a normal appendix but a new finding of right ovarian venous thrombosis. To date, only nine cases of idiopathic OVT have been reported. In this case report, we report a summary of these cases and review of literature regarding management of OVT...
December 8, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27930461/odontogenic-orofacial-infections
#3
Dario Bertossi, Antonio Barone, Antonio Iurlaro, Simone Marconcini, Daniele De Santis, Marco Finotti, Pasquale Procacci
Acute dental abscess is a frequent and sometimes underestimated disease of the oral cavity. The acute dental abscess usually occurs secondary to caries, trauma, or failed endodontic treatment. After the intact pulp chamber is opened, colonization of the root canals takes place with a variable set of anaerobic bacteria, which colonize the walls of the necrotic root canals forming a specialized mixed anaerobic biofilm. Asymptomatic necrosis is common. However, abscess formation occurs when these bacteria and their toxic products breach into the periapical tissues through the apical foramen and induce acute inflammation and pus formation...
December 7, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27929242/community-acquired-pneumonia-in-adults-diagnosis-and-management
#4
Alexander Kaysin, Anthony J Viera
Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and lung examination findings. Diagnosis should be confirmed by chest radiography or ultrasonography. Validated prediction scores for pneumonia severity can guide the decision between outpatient and inpatient therapy. Using procalcitonin as a biomarker for severe infection may further assist with risk stratification...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27928730/guided-growth-may-not-be-the-best-option-for-knee-valgus-deformity-in-adolescent-patients-with-morquio-a
#5
D Colmenares-Bonilla, M Vasconcelos-Martinez, J Guerra-Jasso, L Ocampo-Perez
INTRODUCTION: Valgus deformity in knees is a common concern in Morquio-A patients, preceding premature arthrosis and pain leading to walking disability and loss of ambulatory status. Treatment alternative is the guided growth, but this is sometimes not applied on time. Due to short height reached on these patients, not all will benefit from guided growth surgery. PURPOSE: The purpose of this study is to describe early results of physeal osteotomy for acute valgus correction in adolescent patients and those almost at height peak to achieve alignment...
December 7, 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27923222/pediatric-primary-diffuse-leptomeningeal-primitive-neuroectodermal-tumor-a-case-report-and-literature-review
#6
Jesna Mathew Sublett, Caitlin Davenport, Howard Eisenbrock, Shamsher Dalal, Syed A Jaffar Kazmi, Amir Kershenovich
BACKGROUND: Primary diffuse leptomeningeal primitive neuroectodermal tumor (PDL PNET) is extremely rare, with only 19 cases reported in the literature to date. We present a case of a child with rapidly progressive PDL PNET and a literature review. A 10-year-old boy presented with mood lability, hallucinations, generalized pain, enuresis, and headaches. Initial investigation failed to produce a diagnosis. The symptoms progressed to seizure, back pain, and papilledema. Imaging showed acute hydrocephalus and mild diffuse leptomeningeal enhancement without an identifiable primary lesion...
December 7, 2016: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27922495/toxic-and-endocrine-myopathies
#7
Hans D Katzberg, Charles D Kassardjian
PURPOSE OF REVIEW: This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies. RECENT FINDINGS: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy. Recently proposed mechanisms of injury in patients with critical illness myopathy include inhibition of protein synthesis, mitochondrial dysfunction, disruption of the ubiquitin-proteasome system, oxidative stress, and disruption of intramuscular calcium homeostasis, which can cause a myosin-loss myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27920802/the-role-of-drugs-in-bone-pain
#8
REVIEW
Francesco Marras, Paolo Tranquilli Leali
: Painful symptomatology in the skeletal system can be found in various pathological conditions and can be either localised or diffused. Bone tenderness is common in those who are of an elderly age. TREATMENT STRATEGY: Patients should be informed of the possible causes of their pain and the different therapies that could alleviate it; furthermore they should be encouraged to have an active role in their therapy. It is necessary to prevent the onset of the pain (by the clock) by considering the biological half-life, the bioavailability and the duration of action of the therapy...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27919449/nonsteroidal-anti-inflammatory-drugs-may-affect-cytokine-response-and-benefit-healing-of-combat-related-extremity-wounds
#9
Felipe A Lisboa, Matthew J Bradley, Matthew T Hueman, Seth A Schobel, Beverly J Gaucher, Edda L Styrmisdottir, Benjamin K Potter, Jonathan A Forsberg, Eric A Elster
BACKGROUND: After adequate operative debridement and antimicrobial therapies, combat-related extremity wounds that either heal or fail are both associated with a distinct inflammatory response. Short-term use of nonsteroidal anti-inflammatory drugs in postoperative pain management may affect this response and, by consequence, the healing potential of these wounds. We investigated whether patients treated with nonsteroidal anti-inflammatory drugs had a distinct inflammatory response; different rates of critical colonization, defined as >10(5) colony forming units on quantitative bacteriology; and healing potential...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27918744/efficacy-of-naproxen-with-or-without-esomeprazole-for-pain-and-inflammation-in-patients-after-bilateral-third-molar-extractions-a-double-blinded-crossover-study
#10
G-M Weckwerth, L-F Simoneti, P Zupelari-Gonçalves, A-M Calvo, D-T Brozoski, T-J Dionísio, E-A Torres, J-R Lauris, F-A Faria, C-F Santos
BACKGROUND: Using a double-blinded randomized crossover design, this study aimed to evaluate acute postoperative pain management, swelling and trismus in 46 volunteers undergoing extractions of the two lower third molars, in similar positions, at two different appointments who consumed a tablet of either NE (naproxen 500 mg + esomepraz ole 20 mg) or only naproxen (500 mg) every 12 hours for 4 days. MATERIAL AND METHODS: Parameters were analyzed: self-reported pain intensity using a visual analog scale (VAS) pre- and postoperative mouth opening; incidence, type and severity of adverse reactions; total quantity consumed of rescue medication; and pre- and postoperative swelling...
December 6, 2016: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/27917456/acute-septic-arthritis-of-the-temporomandibular-joint-derived-from-otitis-media-a-report-and-review-of-the-english-and-japanese-literature
#11
Shigeo Ishikawa, Tomoo Watanabe, Mitsuyoshi Iino
Septic arthritis of the temporomandibular joint (SATMJ) is an extremely rare disease with characteristic features of preauricular pain, swelling, redness, and malocclusion. The present report describes a case of SATMJ derived from otitis media, which resulted in a good outcome. We also reviewed the English and Japanese literature with special interest in etiology. It is generally agreed that contiguous or distant infection and trauma are common etiological factors of SATMJ. So far, these etiological factors are mainly discussed based on hypotheses rather than sufficient evidence...
December 5, 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27913538/sickle-cell-disease-when-and-how-to-transfuse
#12
Jo Howard
Blood transfusion remains an important therapeutic intervention in patients with sickle cell disease (SCD), aiming to both increase the oxygen carrying capacity of blood and to reduce the complications of vaso-occlusion. Simple, manual exchange and automated exchange can be effective in reducing the acute and chronic complications of SCD, and the advantages and disadvantages of each methodology mean they all have a role in different situations. Evidence for the role of emergency transfusion in the management of the acute complications of SCD, including acute pain and acute chest syndrome, comes from observational data...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27911127/immediate-and-lasting-effects-of-a-thoracic-spine-manipulation-in-a-patient-with-signs-of-cervical-radiculopathy-and-upper-extremity-hyperalgesia-a-case-report
#13
Beth K Deschenes, Jason Zafereo
Patients with cervical radiculopathy (CR) may present with accompanying symptoms of hyperalgesia, allodynia, heaviness in the arm, and non-segmental pain that do not appear to be related to a peripheral spinal nerve. These findings may suggest the presence of central or autonomic nervous system involvement, requiring a modified management approach. The purpose of this case report is to describe the treatment of a patient with signs of CR and upper extremity (UE) hyperalgesia who had a significant decrease in her UE pain and hypersensitivity after a single thoracic spine manipulation (TSM)...
December 2, 2016: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/27910870/antinociceptive-profile-of-levo-tetrahydropalmatine-in-acute-and-chronic-pain-mice-models-role-of-spinal-sigma-1-receptor
#14
Dong-Wook Kang, Ji-Young Moon, Jae-Gyun Choi, Suk-Yun Kang, Yeonhee Ryu, Jin Bong Park, Jang-Hern Lee, Hyun-Woo Kim
We have recently reported that repeated systemic treatments of extract from Corydalis yanhusuo alleviate neuropathic pain and levo-tetrahydropalmatine (l-THP) is one of active components from Corydalis. We designed this study to investigate antinociceptive effect of l-THP in acute and chronic pain models and related mechanism within the spinal cord. We found that intraperitoneal pretreatment with l-THP significantly inhibited the second phase of formalin-induced pain behavior. In addition, intrathecal as well as intraperitoneal pretreatment with l-THP reduced the mechanical allodynia (MA) induced by direct activation of sigma-1 receptor (Sig-1)...
December 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27908839/the-transition-of-acute-postoperative-pain-to-chronic-pain-an-integrative-overview-of-research-on-mechanisms
#15
C Richard Chapman, Charles J Vierck
The nature of the transition from acute to chronic pain still eludes explanation, but chronic pain resulting from surgery provides a natural experiment that invites both clinical epidemiological investigation and basic scientific inquiry into the mechanisms of this transition. The primary purpose of this paper is to review current knowledge and hypotheses on the transition from acute to persistent postsurgical pain, summarizing literature on clinical epidemiological studies of persistent postsurgical pain development, as well as basic neurophysiological studies targeting mechanisms in the periphery, spinal cord, and brain...
November 28, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27908462/a-rare-case-of-perforated-sub-hepatic-appendicitis-a-challenging-differential-diagnosis-of-acute-abdomen-based-on-the-combination-of-appendicitis-and-maldescent-of-the-caecum
#16
Costanza Chiapponi, Olof Jannasch, Manuela Petersen, Wiebke Lessel, Christiane Bruns, Frank Meyer
Unusual locations of the appendix vermiformis can result in delay in appropriate diagnosis and treatment of appendicitis. So an inflamed appendix in a sub-hepatic caecum caused by caecal maldescent for example can mimic cholecystitis, the pain being localized in the right upper quadrant. Here, we present a case of perforated sub-hepatic appendicitis with peritonitis, requiring open ileocaecal resection. Review of the existing literature has demonstrated that this pathology is uncommon, yet not so rare as one might presume...
November 21, 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27906937/transversus-abdominis-plane-block-in-the-management-of-acute-postoperative-pain-syndrome-after-caesarean-section-a-randomized-controlled-clinical-trial
#17
Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Tullio Pozone, Giuseppe Paladini, Gaspare Carta, Stefano Necozione, Battista Borghi, Franco Marinangeli
BACKGROUND: The international literature is unclear regarding the analgesic efficacy of the transversus abdominis plane block (TAPB) after a Caesarean section (CS). OBJECTIVES: The aim of this study was to determine whether a correctly performed ultrasound-guided TAPB (USG-TAPB) could provide better control of acute postoperative pain during the first 72 hours after CS and if it could provide a faster postoperative recovery. STUDY DESIGN: A double-blind, randomized, controlled clinical trial on pregnant women who underwent CS...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27905910/is-standardized-care-feasible-in-the-emergency-setting-a-case-matched-analysis-of-patients-undergoing-laparoscopic-cholecystectomy
#18
Fabian Grass, Matthieu Cachemaille, Catherine Blanc, Nicolas Fournier, Nermin Halkic, Nicolas Demartines, Martin Hübner
BACKGROUND: Immediate laparoscopic cholecystectomy is the accepted standard for the treatment of acute cholecystitis. The aim of the present study was to evaluate the feasibility of a standardized approach with tailored care maps for pre- and postoperative care by comparing pain, nausea and patient satisfaction after elective and emergent laparoscopic cholecystectomy. METHODS: From January 2014 until April 2015, data on pain and nausea management were prospectively recorded for all elective and emergency procedures in the department of visceral surgery...
December 1, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27904265/a-study-of-intravenous-administration-of-vitamin-c-in-the-treatment-of-acute-herpetic-pain-and-postherpetic-neuralgia
#19
Min Sung Kim, Dong Jin Kim, Chan Ho Na, Bong Seok Shin
BACKGROUND: Although there are several available management strategies for treatment of both acute pain of herpes zoster (HZ) and postherpetic neuralgia (PHN), it is difficult to treat them adequately. OBJECTIVE: The aim of this study was to evaluate the efficacy of intravenously administrated vitamin C on acute pain and its preventive effects on PHN in patients with HZ. METHODS: Between September 2011 and May 2013 eighty-seven patients who were admitted for HZ were assessed according to age, sex, underlying diseases, duration of pain and skin lesion, dermatomal distribution, and PHN...
December 2016: Annals of Dermatology
https://www.readbyqxmd.com/read/27903774/-they-shouldn-t-be-coming-to-the-ed-should-they-a-descriptive-service-evaluation-of-why-patients-with-palliative-care-needs-present-to-the-emergency-department
#20
Emilie Green, Sarah Ward, Will Brierley, Ben Riley, Henna Sattar, Tim Harris
BACKGROUND: Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. METHODS: This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period...
November 30, 2016: American Journal of Hospice & Palliative Care
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