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thoracic pain

Élizabeth Lalande, Chantal Guimont, Marcel Émond, Marc Charles Parent, Claude Topping, Brice Lionel Batomen Kuimi, Valérie Boucher, Natalie Le Sage
OBJECTIVES: The main objective of this study was to evaluate the feasibility of emergency department (ED) point-of-care ultrasound (PoCUS) for rib fracture diagnosis in patients with minor thoracic injury (mTI). Secondary objectives were to 1) evaluate patients' pain during the PoCUS procedure, 2) identify the limitations of the use of PoCUS technique, and 3) compare the diagnosis obtained with PoCUS to radiography results. METHODS: Adult patients who presented with clinical suspicion of rib fractures after mTI were included...
October 17, 2016: CJEM
Donald Nuss, Robert J Obermeyer, Robert E Kelly
Repair of pectus excavatum began at the beginning of the 20(th) century before endotracheal intubation was standard practice. Surgeons therefore developed techniques that corrected the deformity using an open procedure via the anterior chest wall. Initial techniques were unsatisfactory, but by the 1930s the partial rib resection and sternal osteotomy technique had been developed and was used in combination with external traction post-operatively to prevent the sternum from sinking back into the chest. In 1949, Ravitch recommended complete resection of the costal cartilages and complete mobilization of the sternum without external traction, and in 1961 Adkins and Blades introduced the concept of a substernal strut for sternal support...
September 2016: Annals of Cardiothoracic Surgery
Hanlu Zhang, Yingcai Geng, Yu Zheng, Yun Wang
A 68-year-old female was admitted to our hospital with an acute episode of chest pain, progressive cough and fever. She underwent trans-subxiphoid video-assisted thoracoscopic extended thymectomy (TsVATET) for thymoma with myasthenia gravis (MG) 9 days ago. Chest computed tomography (CT) showed anterior mediastinal oedema, and infiltrative findings involved bilateral lung. Physical examination revealed the subxiphoid wound suppuration. We diagnosed subxiphoid incision infection, anterior mediastinitis and concomitant bilateral pneumonia...
September 2016: Journal of Thoracic Disease
Ashutosh Sahu, Rajnish Kumar, Mumtaz Hussain, Ajit Gupta, K H Raghwendra
BACKGROUND: Regional anesthesia using paravertebral block has been suggested as an ideal adjunct to general anesthesia for modified radical mastectomy. Paravertebral block is an effective management of peri-operative pain for Modified radical mastectomy, however, there are no established guidelines regarding what is the most suitable strategy when varying drugs and dosages between different groups. AIM: To evaluate the effectiveness of paravertebral block comparing the most frequently employed drugs in this procedure (bupivacaine vs ropivacaine)...
September 2016: Anesthesia, Essays and Researches
S Parthasarathy, R Sripriya, N Krishnaveni
Intestinal obstruction is associated with significant morbidity and mortality. Scientific assessment of the cause, site of obstruction, appropriate correction of the fluid deficit and electrolyte imbalance with preoperative stabilization of blood gases is ideal as a preoperative workup. Placement of a preoperative epidural catheter especially in the thoracic interspace takes care of perioperative pain and stress reduction. Intraoperative management by controlled general anesthesia administering a relative high inspired fraction of oxygen with invasive monitoring in selected sick cases is mandatory...
September 2016: Anesthesia, Essays and Researches
Benjamin A Keller, Sandra K Kabagambe, James C Becker, Y Julia Chen, Laura F Goodman, Julianna M Clark-Wronski, Kenneth Furukawa, Rebecca A Stark, Amy L Rahm, Shinjiro Hirose, Gary W Raff
BACKGROUND: Multimodal pain management strategies are used for analgesia following pectus excavatum repair. However, the optimal regimen has not been identified. We describe our early experience with intercostal cryoablation for pain management in children undergoing the Nuss procedure and compare early cryoablation outcomes to our prior outcomes using thoracic epidural analgesia. METHODS: A multi-institutional, retrospective review of fifty-two patients undergoing Nuss bar placement with either intercostal cryoablation (n=26) or thoracic epidural analgesia (n=26) from March 2013 to January 2016 was conducted...
September 28, 2016: Journal of Pediatric Surgery
F Vandenbos, D Pop, C Perrotin, N Venissac, J Mouroux
INTRODUCTION: Lung resection for cancer is the cause of significant postoperative pain. The aim of this study was to determine whether pulmonary rehabilitation could induce a resurgence of pain. METHODS: In 2014 and 2015, pulmonary rehabilitation was offered to all patients referred to our institution after lung resection for cancer. Patients were assessed at entry and departure for nociceptive pain, neuropathic pain (DN4), for quality of life using questionnaire EORTC QlQ-C30 and for anxiety and depression (HAD questionnaire)...
October 12, 2016: Revue des Maladies Respiratoires
Julia R Dahlqvist, Christoffer R Vissing, Gitte Hedermann, Carsten Thomsen, John Vissing
PURPOSE: The aim of this study was to investigate the age-related changes in fatty replacement and cross sectional area (CSA) of cervical, thoracic and lumbar paraspinal muscles vs. leg muscles in healthy adults, and to test for association between muscle fat fraction and lifestyle factors. METHODS: Fifty-three healthy adults (24-76 years) were included. Dixon MRI technique was used to determine CSA and quantify fat fraction of paraspinal and leg muscles. Muscle CSA and fat fractions were tested for association with age and muscle strength...
October 13, 2016: Medicine and Science in Sports and Exercise
Ying Wei, Xinhai Shan
The authors' purpose was to test the effect of asymmetric hand lifting on muscular activation patterns of 3 bilateral extensors. Eighteen male university students without back pain were volunteered. Each performed flexion-extension randomly with conditions of right lifting, left lifting, and nonlifting. Surface electromyography from bilateral thoracic, lumbar erector spinae, and hamstring was recorded. The cross-correlation and relative intensity in paired muscles of bilateral extensors was calculated in flexion as well as extension period...
October 14, 2016: Journal of Motor Behavior
J Laulan
Neurogenic thoracic outlet syndrome (TOS) is one of the most controversial pain syndromes of the upper limbs. The controversies revolve around both the diagnosis and treatment of the non-specific or subjective subtypes. Their diagnosis rests on a combination of history, suggestive symptoms and clinical examination. Proximal pain is primarily muscular in origin, while distal symptoms may be the result of intermittent nerve compression and/or myofascial pain syndrome. Stringent clinical criteria are required to confirm the diagnosis of subjective TOS...
June 2016: Hand Surgery and Rehabilitation
Abolfazl Rahimizadeh, Housain Soufiani, Valliolah Hassani, Ava Rahimizadeh
In this study the authors report the first example of spinal pseudarthrosis in a patient with ochronosis, and they describe the application of posterior-only 360° surgery as an alternative approach to combined anterior-posterior surgery in the management of pseudarthrosis of an ankylosed spine, regardless of its etiology. Spinal involvement in ochronosis produces loss of flexibility and ankylosis of thoracic and lumbar segments. Pseudarthrosis is a serious complication of the diseases that present with ankylosis of the spine...
October 14, 2016: Journal of Neurosurgery. Spine
Yasunori Iida, Tsutomu Ito, Yu Inaba, Sachiko Hayashi, Takahiko Misumi, Hideyuki Shimizu
A 43-year-old woman with abdominal and back pain during childbirth consulted us 1 day postdelivery. Contrast-enhanced computed tomography (CT) revealed partially thrombosed type A aortic dissection with intimal tear in the proximal descending thoracic aorta. Conservative antihypertensive treatment was started. However, her abdominal pain progressively deteriorated. Repeat CT revealed narrowing of the descending aorta true lumen and progressive bowel malperfusion. Total arch replacement was urgently performed using the frozen elephant trunk technique...
2016: Annals of Vascular Diseases
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
Leanda McKenna, Xavier Cornwall, Sian Williams
BACKGROUND: Scapular orientation may be influenced by static body posture (sitting and standing) and contribute to the development of shoulder pain. Therefore a consistent body posture should be considered when assessing scapular orientation as well as enhancing optimal scapular positioning. OBJECTIVE: To determine if there are differences in scapular orientation between standing, neutral sitting and habitual sitting, while adjusting for spinal posture. DESIGN: A single group randomised repeated measures study...
October 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Sanjay Dandamudi, Jeremy D Collins, James C Carr, Pat Mongkolwat, Amir A Rahsepar, Todd T Tomson, Nishant Verma, Rishi Arora, Alex B Chicos, Susan S Kim, Albert C Lin, Rod S Passman, Bradley P Knight
RATIONALE AND OBJECTIVES: Studies reporting the safety of magnetic resonance imaging (MRI) in patients with a cardiac implantable electronic device (CIED) have mostly excluded examinations with the device in the magnet isocenter. The purpose of this study was to describe the safety of cardiac and thoracic spine MRI in patients with a CIED. MATERIALS AND METHODS: The medical records of patients with a CIED who underwent a cardiac or thoracic spine MRI between January 2011 and December 2014 were reviewed...
October 4, 2016: Academic Radiology
Li-Qiang Yang, Wei-Yi Gong, Xiao-Ping Wang, Zhi Dou, Yuan-Jie Zeng, Jia-Xiang Ni
BACKGROUND: Patients with thoracic neuropathic pain often do not respond to medication and physical therapy. Coblation technology has been demonstrated to have potential for pain management. METHODS: Fifteen patients underwent computed tomography-guided percutaneous coblation to ablate the thoracic paravertebral nerve for their medication-resistant thoracic neuropathic pain. The pain intensity was assessed by visual analog scale (VAS) 1 day before surgery and 1 week and 1, 3, and 6 months after surgery, and the difference between preoperative and postoperative VAS values was determined to evaluate the pain relief effectiveness...
October 7, 2016: Pain Practice: the Official Journal of World Institute of Pain
Ahmad Jabir Rahyussalim, Ifran Saleh, M Fajrin Armin, Tri Kurniawati, Ahmad Yanuar Safri
INTRODUCTION: Intraoperative neurophysiologic monitoring (IONM) had important role related to the complications in spinal surgery. Somatosensory Evoked Potential (SSEP), Transcranial electric Muscle Evoked Potentials (tceMEPs), and free run EMG are parameters used to asses functional integrity of the nervous system during surgical procedures. Once warning signal was recognized, surgeon have to make a precise decision to overcome that problem. PRESENTATION OF CASE: We present a 47-year old male with back pain due to compression fracture of thoracic vertebra T12 and lumbar vertebrae L1...
September 23, 2016: International Journal of Surgery Case Reports
Rikard Ambrus, Rune B Strandby, Niels H Secher, Kim Rünitz, Morten B S Svendsen, Lonnie G Petersen, Michael P Achiam, Lars B Svendsen
BACKGROUND: Thoracic epidural analgesia (TEA) is used for pain relief during and after abdominal surgery, but the effect of TEA on the splanchnic microcirculation remains debated. We evaluated whether TEA affects splanchnic microcirculation in the pig. METHODS: Splanchnic microcirculation was assessed in nine pigs prior to and 15 and 30 min after induction of TEA. Regional blood flow was assessed by neutron activated microspheres and changes in microcirculation by laser speckle contrast imaging (LSCI)...
October 6, 2016: BMC Anesthesiology
Peter Stilwell, Katherine Harman, William Hsu, Brian Seaman
BACKGROUND: Musculoskeletal injuries stemming from forceful muscular contractions during seizures have been documented in the literature. Reports of multiple seizure-induced spinal fractures, in the absence of external trauma and without risk factors for fracture, are rare. CASE PRESENTATION: A 28-year-old male, newly diagnosed with epilepsy, presented to a chiropractic clinic with the complaint of mid-thoracic pain beginning after a tonic-clonic seizure with no associated external trauma...
September 2016: Journal of the Canadian Chiropractic Association
Dario Amore, Francesco S Cerqua, Fabio Perrotta, Antonio Cennamo, Carlo Curcio
INTRODUCTION: The mediastinal bronchogenic cysts represents 50%-60% of mediastinal cysts and rarely occurs in the posterior mediastinum. The final surgical resection is indicated for symptomatic patients and is recommended for some asymptomatic patients in order to establish the diagnosis and to avoid any subsequent complications. CASE PRESENTATION: We report a case of 17 years-old male suffering from bronchogenic cysts of the mediastinum. The patient was admitted to our hospital complaining with dry chough and dyspnea; CT scan showed a cystic mass in posterior mediastinum...
September 23, 2016: International Journal of Surgery Case Reports
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