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https://www.readbyqxmd.com/read/29471560/knochensarkome
#1
Jendrik Hardes, Georg Gosheger, Timo Budny
Bone sarcomas are extremely rare representing approximately 0.2% among all cancer types. Due to the rarity of these tumors both the patients and the physicians can overlook or misinterpret the first often unspecific symptoms of these tumors (pain, limping and swelling). Therefore, radiographic examination (X-ray and/or MRI) of the involved region in case of inexplicable symptoms is strongly recommended. The most common primary malignant bone tumor entity is osteosarcoma, followed by chondrosarcoma and Ewing sarcoma...
February 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29471504/anodyne-by-design-measuring-the-prevalence-of-esoteric-designer-opioids-in-pain-management-patients
#2
Melissa M Goggin, Stephanie D Gozum, Anna Miller, Gregory C Janis
The recent increase in illicit opioids sold on the black market, cut into heroin and masqueraded as prescription pills prompts a significant public health concern. Most designer opioids possess unknown potencies and unknown pharmacokinetics and their unregulated, variable dosages lead to rashes of overdoses. Additionally, many of the designer opioids, especially the fentanyl analogs are significantly more potent than heroin. High-profile cases involving overdoses of U-47700 and carfentanil have been reported in the media; however, the true prevalence of these and other designer opioids is unknown...
February 17, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29470828/enhancement-of-dissolution-and-skin-permeability-of-pentazocine-by-proniosomes-and-niosomal-gel
#3
Asadullah Madni, Muhammad Abdur Rahim, Muhammad Ahmad Mahmood, Abdul Jabar, Mubashar Rehman, Hassan Shah, Arshad Khan, Nayab Tahir, Aamna Shah
Proniosomes (PN) are the dry water-soluble carrier systems that may enhance the oral bioavailability, stability, and topical permeability of therapeutic agents. The low solubility and low oral bioavailability due to extensive first pass metabolism make Pentazocine as an ideal candidate for oral and topical sustained release delivery. The present study was aimed to formulate the PNs by quick slurry method that are converted to niosomes (liquid dispersion) by hydration, and subsequently formulated to semisolid niosomal gel...
February 22, 2018: AAPS PharmSciTech
https://www.readbyqxmd.com/read/29470801/episodic-breathlessness-in-patients-with-advanced-cancer-characteristics-and-management
#4
REVIEW
Sebastiano Mercadante
The aim of this review is to present the way in which episodic breathlessness (EB) has been recognized over the years, with regard to definition, characteristics, and management of these acute episodes that have serious consequences for patients. EB is characterized by a sudden increase in intensity of dyspnea over a short duration of time, leading to high levels of anxiety. A significant aggravation of dyspnea may occur in patients with a background of dyspnea or intermittently even without basal breathlessness...
February 22, 2018: Drugs
https://www.readbyqxmd.com/read/29470716/denosumab-a-potential-treatment-option-for-aneurysmal-bone-cyst-of-the-atlas
#5
REVIEW
Ravish Shammi Patel, Chetan Anil Dhamne, Anil Gopinathan, Nishant Kumar, Naresh Kumar
PURPOSE: Aneurysmal bone cysts (ABCs) of spine are conventionally treated with en-bloc resection or intralesional excision/curettage and reconstruction or filling of defects with bone cement. For the treatment of upper cervical ABCs, en-bloc resections are often not desirable considering the risk/benefit ratio while the risk of recurrence after intralesional excision is high. Hence, alternative management options are often necessary. We describe our clinical experience with one such treatment alternative-denosumab for the treatment of ABC of Atlas...
February 22, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29470544/validation-of-the-what-matters-index-a-brief-patient-reported-index-that-guides-care-for-chronic-conditions-and-can-substitute-for-computer-generated-risk-models
#6
John H Wasson, Lynn Ho, Laura Soloway, L Gordon Moore
INTRODUCTION: Current health care delivery relies on complex, computer-generated risk models constructed from insurance claims and medical record data. However, these models produce inaccurate predictions of risk levels for individual patients, do not explicitly guide care, and undermine health management investments in many patients at lesser risk. Therefore, this study prospectively validates a concise patient-reported risk assessment that addresses these inadequacies of computer-generated risk models...
2018: PloS One
https://www.readbyqxmd.com/read/29470291/recurrent-abdominal-pain-in-children-summary-evidence-from-3-systematic-reviews-of-treatment-effectiveness
#7
Rebecca A Abbott, Alice E Martin, Tamsin V Newlove-Delgado, Alison Bethel, Rebecca S Whear, Jo Thompson Coon, Stuart Logan
OBJECTIVES: Between 4% and 25% of school-aged children complain of recurrent abdominal pain (RAP) severe enough to interfere with their daily activities. METHODS: We carried out a systematic review of randomised controlled trials (RCTs) in eleven databases and 2 trials registries from inception to June 2016. An update search was run in November 2017. All screening was performed by 2 independent reviewers. Included studies were appraised using the Cochrane risk of bias tool and the evidence assessed using GRADE...
February 21, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29470277/does-duration-of-pain-at-baseline-influence-clinical-outcomes-of-low-back-pain-patients-managed-on-an-evidence-based-pathway
#8
Mary-Anne Jess, Ryan Cormac, Sharon Hamilton, Shaun Wellburn, Greg Atkinson, Charles Greenough, Andrew Coxon, Diarmaid Ferguson, Francis Fatoye, John Dickson, Andrea Jones, Denis Martin
Supplemental Digital Content is available in the text STUDY DESIGN.: Longitudinal observational study. OBJECTIVE: To investigate the association between the duration of pain at baseline and the clinical outcomes of patients with low back pain (LBP) enrolled on the North East of England Regional Back Pain and Radicular Pain Pathway (NERBPP). SUMMARY OF BACKGROUND DATA: The NERBPP is a clinical pathway based upon NICE guidelines (2009) for LBP of <1-year duration...
February 21, 2018: Spine
https://www.readbyqxmd.com/read/29470237/primary-shoulder-hemiarthroplasty-what-can-be-learned-from-359-cases-that-were-surgically-revised
#9
Daniel J Hackett, Jason E Hsu, Frederick A Matsen
BACKGROUND: Primary shoulder hemiarthroplasty is used to address a range of glenohumeral disorders, including fracture, arthritis, avascular necrosis, and capsulorrhaphy arthropathy; some patients with hemiarthroplasties undergo revision surgery for persistent pain or residual shoulder dysfunction. The literature does not clarify the features of the hemiarthroplasties having repeat surgery in a way that can guide surgeons' efforts to minimize the need for revision. To help address this gap, we analyzed the characteristics of patients from our region for whom we performed surgical revision of a prior humeral hemiarthroplasty QUESTIONS/PURPOSES: (1) What are the common characteristics of shoulder hemiarthroplasties having a revision? (2) What are the common characteristics of the subset of revised shoulder hemiarthroplasties that were performed for fracture? (3) What are characteristics of the subset of all revised hemiarthroplasties that were associated with glenoid bone erosion? METHODS: Data for 983 patients for whom we performed a surgical revision of any type of shoulder arthroplasty between January 1991 and January 2017 were identified in our longitudinally maintained institutional arthroplasty revision database...
February 21, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29470002/complementary-therapies-for-pain-among-individuals-receiving-hemodialysis-a-systematic-review
#10
Savannah Zins, Cynthia R Gross, Edwin D Huff, Mary Catherine Hooke
Pain is a major problem for individuals undergoing hemodialysis and can lead to decreased quality of life when ineffectively managed. Pain is often reported as burdensome; thus, nurses must learn effective, nonpharmacological adjuncts to help care for symptomatic patients. The purpose of this review was to identify non-pharmacologic complementary therapies and evaluate their effectiveness in minimizing pain among individuals undergoing hemodialysis. Multiple complementary interventions were identified, and several reduced pain, but evidence is qualified by limitations in study methods...
January 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29469176/current-physiotherapy-practice-in-the-management-of-tennis-elbow-a-service-evaluation
#11
M Bateman, E Whitby, S Kacha, E Salt
BACKGROUND: Tennis elbow is a common painful condition that may affect daily function and ability to work. Physiotherapy is the most commonly used primary intervention but there is a wide range of treatment options within the umbrella of physiotherapy. Our aim was to report on the treatments that are currently used by physiotherapists in a UK National Health Service (NHS) setting. METHODS: A retrospective service evaluation was conducted at two NHS hospital trusts by reviewing patient attendance records over a 1-year period...
February 22, 2018: Musculoskeletal Care
https://www.readbyqxmd.com/read/29469076/quality-of-life-outcome-measures-using-university-of-washington-questionnaire-version-4-in-early-t1-t2-anterior-tongue-cancers-with-and-without-radiotherapy-a-cross-sectional-study
#12
P Sakthivel, D V K Irugu, C A Singh, H Verma, R Yogal, B Jat, A Chadran, K Sikka, A Thakar, S C Sharma
CONTEXT: To evaluate the quality of life (QOL) outcome measures in disease-free survivors of pathological T1/T2 tongue cancers and to compare QOL in patients treated with only surgery and with adjuvant treatment. SETTINGS AND DESIGN: Cross-sectional survey. PATIENTS AND METHODS: All pathological T1/T2 anterior tongue cancer cases with follow-up from January 2011 till December 2015, who had locoregionally controlled disease with a minimum disease-free survival period of 1 year, were included in the study...
April 2017: Indian Journal of Cancer
https://www.readbyqxmd.com/read/29468939/objectively-measuring-pain-using-facial-expression-is-the-technology-finally-ready
#13
Thomas Richard Dawes, Ben Eden-Green, Claire Rosten, Julian Giles, Ricardo Governo, Francesca Marcelline, Charles Nduka
Currently, clinicians observe pain-related behaviors and use patient self-report measures in order to determine pain severity. This paper reviews the evidence when facial expression is used as a measure of pain. We review the literature reporting the relevance of facial expression as a diagnostic measure, which facial movements are indicative of pain, and whether such movements can be reliably used to measure pain. We conclude that although the technology for objective pain measurement is not yet ready for use in clinical settings, the potential benefits to patients in improved pain management, combined with the advances being made in sensor technology and artificial intelligence, provide opportunities for research and innovation...
February 22, 2018: Pain Management
https://www.readbyqxmd.com/read/29468642/sensory-distribution-of-the-lateral-femoral-cutaneous-nerve-block-a-randomised-blinded-trial
#14
M Nersesjan, D Hägi-Pedersen, J H Andersen, O Mathiesen, J B Dahl, L Broeng, K H Thybo
BACKGROUND: The lateral femoral cutaneous nerve (LFCN) block may be used for post-operative pain management in patients undergoing total hip arthroplasty. The aim of this trial was to investigate the sensory coverage of the posterior and the lateral incision lines and the involvement of the femoral nerve after an LFCN block. METHODS: The study was a randomised, blinded trial in 20 healthy volunteers. All subjects received a bilateral LFCN block randomised to 8 ml ropivacaine on the right side and 8 ml isotonic saline on the left side, or vice versa...
February 21, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29468218/intravitreal-bevacizumab-as-therapy-for-refractory-neovascular-glaucoma-secondary-to-iris-metastasis-of-breast-carcinoma
#15
Stephanie Vale, Lorena Montalvo, Emilio Baez, Armando L Oliver
Purpose: To report a case of refractory glaucoma secondary to iris metastasis from breast cancer which was successfully treated with intravitreal bevacizumab. Observations: A 72-year-old woman presented with left ocular pain, vision loss and neovascular glaucoma secondary to iris metastasis from breast cancer. A single intravitreal injection of bevacizumab resulted in prolonged resolution of iris neovascularization, reduction of intraocular pressure and ocular pain relief...
March 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29468168/severe-pulmonary-hypertension-due-to-adult-onset-still-s-disease
#16
Ankur Sinha, Ravikaran Patti, Paurush Ambesh, Chukwudi Obiagwu, Namrita Malhan, Kabu Chawla
A 29-year-old female with adult-onset Still's disease (AOSD) presented with progressive shortness of breath both on rest and on exertion, increased abdominal girth, and swelling in both legs. She was on oral prednisone and was recently started on canakinumab (interleukin-1 antagonist) for joint pain and rash of AOSD. Echocardiogram showed severely dilated right ventricle, dilated pulmonary artery, moderately reduced right ventricular systolic function, but with normal left ventricular systolic function. Computed tomography with contrast ruled out pulmonary embolism...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29468096/omental-infarction-the-great-impersonator
#17
Kevin G Buell, Alexandra Burke-Smith, Vishal Patel, Josef Watfah
A 58-year-old female presented to the emergency department with intermittent right upper quadrant pain and nausea. On examination, the patient was tender and Murphy's sign was elicited. A presumptive diagnosis of acute cholecystitis was made but an ultrasound of the abdomen revealed a thin-walled gallbladder without calculi. A computed tomography (CT) scan of the abdomen and pelvis demonstrated fat stranding involving the greater omentum and the right paracolic gutter. The patient was diagnosed with a focal omental infarction and underwent emergency laparoscopic surgery...
December 13, 2017: Curēus
https://www.readbyqxmd.com/read/29468081/progressive-cutaneous-viral-pigmented-plaques-in-three-hungarian-vizslas-and-the-response-of-lesions-to-topical-tigilanol-tiglate-gel
#18
Naomi Hansen, Nikianna Nicholas, Graeme Pack, John T Mackie, Michael Shipstone, John S Munday, Paul Reddell, Geoff Orbell, Richard Malik
Cutaneous pigmented viral plaques is a disorder of epidermal growth caused by canine papillomavirus type 4 (CPV-4). There is currently no standard of care for managing this condition and it has not been reported in the Hungarian Vizsla. This case series documents the clinical features of canine pigmented viral plaques in Hungarian Vizsla dogs and the treatment of a severe case using a novel topical agent tigilanol tiglate (EBC-46). A 4-year-old spayed Hungarian Vizsla in Australia was presented for multiple cutaneous pigmented plaques extending from the ventral cervical region...
February 2018: Veterinary Medicine and Science
https://www.readbyqxmd.com/read/29467886/primary-intrapulmonary-solitary-fibrous-tumours
#19
Xia Lin, Yingming Xiang, Hongcan Shi, Fangbiao Zhang
Due to the extreme rarity of primary intrapulmonary solitary fibrous tumours (SFTs), their clinical course, imaging characteristics, diagnosis, treatment and prognosis are poorly understood. The present study therefore assessed the diagnosis and management of primary intrapulmonary SFTs and systematically reviewed previously reported cases in the literature. A total of 5 patients who underwent resection for primary intrapulmonary SFTs were enrolled in the present study and their clinical course, tumour characteristics, management and survival were assessed in this retrospective study...
March 2018: Oncology Letters
https://www.readbyqxmd.com/read/29467360/atypical-presentation-of-acute-coronary-syndrome-and-importance-of-wellens-syndrome
#20
Kyaw Kyaw, Htun Latt, Sammy San Myint Aung, Nay Min Tun, Wut-Yi Phoo, Htwe Htwe Yin
BACKGROUND Acute coronary syndrome (ACS) is a common and potentially life-threatening condition encountered in emergency departments. Despite its dreaded nature, nearly one-third of ACS present without chest pain and may mislead clinicians. Additionally, Wellens' syndrome is a pre-infarction stage of significant proximal left anterior descending (LAD) artery stenosis, which can lead to extensive anterior wall myocardial infarction without timely intervention.  CASE REPORT We report the case of a 74-year-old woman presenting with isolated throat pain and Wellens' pattern in the initial EKG, which prompted the proper workup and management...
February 22, 2018: American Journal of Case Reports
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