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Emergency department pain

Erdal Tekin, Ali Ahiskalioglu, Muhammed Enes Aydin, Emre Sengun, Atif Bayramoglu, Haci Ahmet Alici
Herpes zoster is a painful, eruptive, viral condition occurring with reactivation in immunosuppressed individuals. The selection of an effective analgesic method in the acute phase of herpes zoster can decrease the incidence of postherpetic neuralgia by reducing neural sensitization. The erector spinae plane block has been reported to provide diffuse and effective analgesia in the cervical, thoracic, and lumbar regions. We report an effective decrease in pain with the application of the high-thoracic erector spinae plane block in the emergency department in a patient with herpes zoster pain in the cervicothoracic and shoulder region...
October 16, 2018: American Journal of Emergency Medicine
Arnaldo Machado, Manuel Carvalho, Jorge Caravana
INTRODUCTION: Roux-en-Y gastric bypass (RYGB) has been the most common surgical operation used to treat obesity and its inherent co-morbidities. Intussusception with bowel obstruction after RYGB is a rare complication and its physiopathology remains unclear. The diagnosis is generally based on typical image of computed tomography (CT) scan and a surgical exploration is generally recommended. CASE PRESENTATION: A 54-year-old female patient with history of a gastric bypass six years before, presented herself on the emergency department with acute onset of abdominal pain, nausea, and nonbilious vomiting...
September 21, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Hamza Ijaz, Christopher Wong, Jennifer Weaver, Trudy Mallinson, Lorna Richards, Maxine A Le Saux, Haijun Wang, Yan Ma, Andrew C Meltzer
BACKGROUND: Shared decision-making (SDM) has been studied in the emergency department (ED) in relation to hospital admissions but not for CT scan utilization. CT scans are a common imaging modality with high accuracy that emit considerable ionizing radiation. This study has three aims: to measure provider and patient preference for SDM; to evaluate patient involvement in the decision to order a CT scan; and to determine the association between patient involvement and CT utilization. METHODS: In this prospective study, stable ED patients with abdominal pain with CT imaging as a likely diagnostic tool, were screened and consented...
September 19, 2018: American Journal of Emergency Medicine
Marie R Waterhouse, Phung K Pham, Todd P Chang
OBJECTIVES: Adolescent female patients who are not sexually active and who present to a pediatric emergency department with abdominal pain require a full bladder prior to transabdominal ultrasound. Procedures to fill the bladder are largely institution or provider dependent. We examined adolescent females' attitudes and opinions toward 2 common methods of bladder filling, intravenous fluid administration and transurethral Foley catheter placement, by means of a Q-sort study. METHODS: Two convenience samples of adolescent female patients in the pediatric emergency department at an academic children's hospital participated in the study...
October 17, 2018: Pediatric Emergency Care
Daniel Paramythiotis, Petros Bangeas, Anestis Karakatsanis, Alexandros Iliadis, Georgia Karayannopoulou, Antonios Michalopoulos
BACKGROUND: A mesenteric chylous cyst is defined as a cyst occurring in the mesentery of the gastrointestinal tract anywhere from the duodenum to the rectum and is diagnosed most often during the fifth decade of life. CASE PRESENTATION: In our case report, we describe a case of 38-year-old Greek woman who presented at our Emergency Department complaining of abdominal pain without any other symptoms. Her medical and family histories were clear and she had never had any abdominal interventions...
October 17, 2018: Journal of Medical Case Reports
Volkan Dogan, Oğuzhan Çelik, Bülent Özlek, Eda Özlek, Cem Çil, Özcan Başaran, Murat Biteker
OBJECTIVES: Allergic myocardial infarction, known as Kounis syndrome, is an acute myocardial infarction after an allergic reaction to food, drugs, or insect stings, etc. Kounis syndrome can also be caused by all kinds of seafood, such as finned fish, molluscan shellfish, cephalopods, and crustacean shellfish. METHODS: Herein, we report a case of a 67-year-old man, with hypertension, referred for itchiness, facial rash, chest pain, and palpitations developed after consumption of blue crab...
October 16, 2018: Acta Clinica Belgica
Ahmet Sami Yazar, Seher Erdoğan, Ceyhan Şahin, Şirin Güven
Yazar AS, Erdoğan S, Şahin C, Güven Ş. Reliability of ultrasonography and the Alvarado scoring system in acute appendicitis. Turk J Pediatr 2018; 60: 173-179. In this study, we aimed to evaluate the diagnostic performance of ultrasonography, the Alvarado score, mean platelet volume and C-reactive protein in the diagnosis of acute appendicitis. Patients admitted to the pediatric emergency department with abdominal pain who were operated on with a preliminary diagnosis of acute appendicitis were evaluated...
2018: Turkish Journal of Pediatrics
Stefan J Friedrichsdorf, Donna Eull, Christian Weidner, Andrea Postier
Introduction: Pain remains common, underrecognized, and undertreated in children's hospitals and pediatric clinics. Over 200,000 patients experience needle pain annually in our institution, caused by blood draws, intravenous access, vaccinations, and injections on all inpatient units, emergency departments, outpatient laboratories, and ambulatory clinics. Objectives: We implemented a hospital-based, system-wide initiative called the "Children's Comfort Promise," and created a new standard of care for needle procedures that required staff to consistently offer 4 strategies: (1) topical anesthetics, (2) sucrose or breastfeeding for infants 0 to 12 months, (3) comfort positioning (including swaddling, skin-to-skin, or facilitated tucking for infants; sitting upright for children), and (4) age-appropriate distraction...
September 2018: Pain Reports (Baltimore, Md.)
Ashraf F Hefny, Adel Z Ayad, Nikolay Matev, Masoud O Bashir
INTRODUCTION: Psyllium in granular dosage form is used as an over - the counter safe laxative drug. It has a considerable hygroscopic propriety which allows it to retain water and expands rapidly to become many times of its original size. PRESENTATION OF THE CASE: 21-year-old man presented to the Emergency Department complaining of lower abdominal pain and constipation for five days. He was discharged home on Psyllium for treatment of the constipation. Two days later, he returned to the Emergency Department complaining of increased abdominal distension without passing any stools...
October 8, 2018: International Journal of Surgery Case Reports
Zlatan Cizmic, Emmanuel Edusei, Afshin A Anoushiravani, Joseph Zuckerman, Ronald Ruden, Ran Schwarzkopf
Poor outcomes associated with increased perioperative opioid use have led investigators to seek alternative pain management modalities after total joint arthroplasty. Nonpharmacological approaches, such as electroceuticals, have shown promise. The purpose of this study was to evaluate the effects of "havening," a specific form of psychosensory therapy, on postoperative pain scores and narcotic consumption. In this prospective, randomized controlled trial, the authors compared 19 patients who underwent psychosensory therapy with 22 patients who served as the control group...
October 15, 2018: Orthopedics
Michael H Guo, Reesa L Monir, Ashleigh Wright, Neal P Holland
BACKGROUND Serotonin syndrome is a common yet potentially life-threatening condition caused by increased serotonergic activity, usually from serotonergic pharmaceutical agents. Primary features of serotonin syndrome include mental status changes, autonomic hyperactivity, and neuromuscular abnormalities. However, the presentation of serotonin syndrome is often quite variable, leading to its under-diagnosis. CASE REPORT A 50-year-old female with chronic kidney disease on peritoneal dialysis presented to the Emergency Department with severe, diffuse body pain...
October 15, 2018: American Journal of Case Reports
Baseer Sultan Ahmad, Adeel Ahmad, Sajjad Jamil, Saiyed Abdullah Abubakar Mohsin Ehsanullah, Abeera Munir
Hepatitis E virus is the etiological agent for Hepatitis E infection, which is congruent to Hepatitis A infection. The clinical spectrum of the disease range from asymptomatic self-limiting disease which requires no treatment to life threatening fulminant liver disease in pregnancy, G6PD deficient and post-liver transplant patients, which necessitate urgent treatment. Similarly we are reporting a case of a 28 year old male with no previous known comorbids, who presented in emergency department with low grade fever, yellow discolouration of eyes and upper abdominal pain for last 5-6 days...
September 2018: JPMA. the Journal of the Pakistan Medical Association
Kassi Shave, Samina Ali, Shannon D Scott, Lisa Hartling
BACKGROUND: Children experience multiple painful procedures when being cared for in emergency departments (EDs). Unfortunately, evidence-based interventions to manage such pain and distress are under-utilized across EDs. Caregivers are uniquely positioned and invested to advocate for the adaptation of such evidence into practice. Our objective was to gather information from caregivers of children experiencing procedural pain in the ED to inform the development of a novel, caregiver-focused knowledge translation (KT) tool...
October 13, 2018: BMC Pediatrics
Cédric Gil-Jardiné, Samantha Al Joboory, Juliane Tortes Saint Jammes, Guillaume Durand, Régis Ribéreau-Gayon, Michel Galinski, Louis-Rachid Salmi, Philippe Revel, Cyril Alexandre Régis, Guillaume Valdenaire, Emmanuel Poulet, Karim Tazarourte, Emmanuel Lagarde
BACKGROUND: Recent data suggest that 10-20% of injury patients will suffer for several months after the event from diverse symptoms, generally referred to as post-concussion-like symptoms (PCLS), which will lead to a decline in quality of life. A preliminary randomized control trial suggested that this condition may be induced by the stress experienced during the event or emergency room (ER) stay and can be prevented in up to 75% of patients with a single, early, short eye movement desensitization and reprocessing (EMDR) psychotherapeutic session delivered in the ER...
October 12, 2018: Trials
Melike Elif Teker, Önder Teskin
BACKGROUND: Primary cardiac sarcoma is a rare and atypical clinical entity. We present a patient with long-term remission after primary cardiac sarcoma resection. CASE REPORT: A 42-year-old previously healthy female presented to the emergency department after an effort-induced 30-minute episode of chest pain and extreme shortness of breath. Physical examination upon admission was remarkable for a pulse of 99/minute; blood pressure was 101/73 mmHg. Transthoracic echocardiography showed a mass measuring 5...
September 25, 2018: Heart Surgery Forum
Robert Ohle, Omar Anjum, Helena Bleeker, Sarah McIsaac
INTRODUCTION: Acute aortic syndrome (AAS) is a time sensitive and difficult to diagnose aortic emergency. The American Heart Association (AHA) proposed the acute aortic dissection detection risk score (ADD-RS) as a means to reduce miss rate and improve time to diagnosis. Previous validation studies were performed in a high prevalence population of patients. We do not know how the rule will perform in a lower prevalence population. This is important because application of a rule with low specificity would increase imaging rates and complications...
October 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Cumhur Murat Tulay, Sadik Yaldiz, Adnan Bilge
Introduction: The duration of pain after rib fracture is the question physicians are most frequently asked. The duration of pain following a traumatic rib fracture without any comorbidity is not widely published. Aim: We report our experience to investigate the duration of pain following isolated traumatic rib fractures without any traumatic comorbidity. Material and methods: We examined 182 patients with isolated rib fracture without any trauma to other body parts...
September 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Caleb Tsetse, Shazia Rahat Chaudhry, Feraas Jabi, Jennifer Nicole Taylor
Acute diverticulitis is a painful condition of the gastrointestinal tract that results from sudden inflammation of one or more diverticula in the bowel wall. Right-sided acute diverticulitis, such as cecal diverticulitis, is uncommon diagnosis that can be easily misdiagnosed as acute appendicitis as it shares similar clinical presentation. An unusual complication of right-sided acute diverticulitis such as perforated cecal diverticulitis has different management from acute appendicitis. Thus, definitive diagnosis of this clinical condition with imaging is crucial to optimal management...
January 2019: Radiology Case Reports
Melissa Corso, Scott Howitt
Background: Knee injuries are the second to fourth most common injuries in youth soccer. In this population, sprains/strains, fractures and contusions are most common. Due to variations in the developing skeleton, it can be difficult to rule out fractures. Case Summary: We present a case of a 13-year-old presenting to the emergency department (ED) with patellar pain after pivoting during a soccer game. After radiographic clearance, he was allowed to return to sport...
August 2018: Journal of the Canadian Chiropractic Association
Dmitry Tumin, Rebecca Miller, Mohammed Hakim, Shabana Z Shafy, David Drees, Sharon Wrona, Timothy P Smith, Joseph D Tobias, Tarun Bhalla
OBJECTIVES: To retrospectively characterize the rate of referrals to an outpatient chronic pain clinic among adolescents with chronic pain, and to identify factors associated with referral. METHODS: Adolescents 13-18 years of age seen in 2010-2015 at outpatient clinics associated with Nationwide Children's Hospital (NCH) and diagnosed with chronic pain were included if they lived near NCH and had not been previously referred to the NCH outpatient chronic pain clinic...
October 9, 2018: Clinical Journal of Pain
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