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Ultrasound and pain management

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https://www.readbyqxmd.com/read/28075090/carpal-tunnel-syndrome-diagnosis-and-management
#1
Jennifer Wipperman, Kyle Goerl
Carpal tunnel syndrome, the most common entrapment neuropathy of the upper extremity, is caused by compression of the median nerve as it travels through the carpal tunnel. Classically, patients with the condition experience pain and paresthesias in the distribution of the median nerve, which includes the palmar aspect of the thumb, index and middle fingers, and radial half of the ring finger. Additional clues include positive physical examination findings, such as the flick sign, Phalen maneuver, and median nerve compression test...
December 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/28074461/acute-appendicitis-during-pregnancy-case-series-of-20-pregnant-women
#2
İlker Murat Arer, Songül Alemdaroğlu, Hasan Yeşilağaç, Hakan Yabanoğlu
BACKGROUND: Acute appendicitis (AA) is the most common cause of acute abdomen during pregnancy. Most of the signs of appendicitis are also found during normal pregnancy period, however, and diagnosis of appendicitis during pregnancy remains challenging. The aim of the current study was to report our clinical experience of AA during pregnancy and investigate optimal management of this difficult situation. METHODS: Records of 20 pregnant women with diagnosis of AA who underwent appendectomy between 2005 and 2015 were included in this study...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28072749/ultrasound-guided-pulsed-radiofrequency-treatment-of-the-cervical-sympathetic-chain-for-complex-regional-pain-syndrome-a-retrospective-observational-study
#3
Eung Don Kim, Woo Joo Yoo, Yoo Na Kim, Hue Jung Park
The stellate ganglion is a common target to manage neuropathic pain in the upper extremities. However, the effect duration of a single stellate ganglion block is often temporary. To overcome the short-term effects of a single sympathetic block, pulsed radiofrequency (PRF) can be applied. The aim of the present study was to investigate the efficacy of PRF on the cervical sympathetic chain under ultrasound guidance for complex regional pain syndrome (CRPS).Twelve CRPS patients who underwent PRF on the cervical sympathetic chain were enrolled in this retrospective analysis...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28050442/pancreatic-tuberculosis-a-puzzle-for-physicians-a-rare-case-and-review-of-literature
#4
Prashanth Ashok Kumar, Gursharan Singh, John Biku Joseph, S Swaminathan, L Venkatakrishnan
Pancreatic Tuberculosis is an uncommon form of extra pulmonary tuberculosis that resembles malignancy of pancreas and serve as a diagnostic challenge for physicians. Conservative management with Anti Tuberculosis Therapy (ATT) will suffice for pancreatic tuberculosis whereas a malignancy may require major surgeries which may lead to significant morbidity. Here, we discuss the case of a female patient who presented with abdominal pain and vomiting and is a known case of chronic calcific pancreatitis. Radiological findings were that of malignancy of the pancreas...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043931/similar-efficacies-of-endoscopic-ultrasound-gallbladder-drainage-with-a-lumen-apposing-metal-stent-vs-percutaneous-transhepatic-gallbladder-drainage-for-acute-cholecystitis
#5
Shayan Irani, Saowanee Ngamruengphong, Anthony Teoh, Uwe Will, Jose Nieto, Barham K Abu Dayyeh, S Ian Gan, Michael Larsen, Hon Chi Yip, Mark D Topazian, Michael J Levy, Christopher C Thompson, Andrew C Storm, Gulara Hajiyeva, Amr Ismail, Yen-I Chen, Majidah Bukhari, Yamile Haito Chavez, Vivek Kumbhari, Mouen A Khashab
BACKGROUND & AIMS: Acute cholecystitis in patients who are not candidates for surgery is often managed with percutaneous transhepatic gallbladder drainage (PT-GBD). Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with a lumen-apposing metal stent (LAMS) is an effective alternative to PT-GBD. We compared the technical success of EUS-GBD vs PT-GBD, as well as patient outcomes, numbers of adverse events (AEs), length of hospital stay, pain scores, and repeat interventions. METHODS: We performed a retrospective study to compare EUS-GBD vs PT-GBD at 7 centers (5 in the United States, 1 in Europe, and 1 in Asia), from 2013 through 2015, in management of acute cholecystitis in patients who are not candidates for surgery...
December 30, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28018749/focused-training-for-humanitarian-responders-in-regional-anesthesia-techniques-for-a-planned-randomized-controlled-trial-in-a-disaster-setting
#6
Adam R Aluisio, Carrei Teicher, Tess Wiskel, Allysia Guy, Adam Levine
BACKGROUND: Lower extremity trauma during earthquakes accounts for the largest burden of geophysical disaster-related injuries. Insufficient pain management is common in disaster settings, and regional anesthesia (RA) has the potential to reduce pain in injured patients beyond current standards. To date, no prospective research has evaluated the use of RA in a disaster setting. This cross-sectional study assesses knowledge translation and skill acquisition outcomes for lower extremity RA performed with and without ultrasound guidance among a cohort of Médecins Sans Frontières (MSF) volunteers who will function as proceduralists in a planned randomized controlled trial evaluating the efficacy of RA for pain management in an earthquake setting...
November 16, 2016: PLoS Currents
https://www.readbyqxmd.com/read/28018077/hip-adductor-pyomyositis-from-streptococcus-mitis-in-a-four-year-old-child
#7
Metin Tolga Buldu, Raghu Raman
: The unique aspect of this case study is the unusual history, presentation, ultrasonography, MRI and blood culture results, which lead to the diagnosis and treatment of adductor pyomyositis with a rare organism in a temperate country. The patient presented with a one-day history of malaise, fever, left groin pain and inability to weight bear on the left leg. There was no history of any trauma, predisposing infections or recent travel. Plain radiograph and ultrasound of the hip was normal with no effusion...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28011032/a-rare-diagnosis-recognizing-and-managing-fungal-tenosynovitis-of-the-hand-and-upper-extremity
#8
Maureen A O'Shaughnessy, Aaron J Tande, Shawn Vasoo, Mark J Enzler, Elie F Berbari, Alexander Y Shin
PURPOSE: Fungal infections involving the tenosynovium of the upper extremity are uncommon and are often misdiagnosed. This study evaluates the epidemiology, diagnosis, treatment, and outcomes of patients with fungal tenosynovitis of the upper extremity over a 20-year period. METHODS: A retrospective review of all culture-confirmed cases of fungal tenosynovitis of the upper extremity treated between 1990 and 2013 at a single institution was performed. Clinical data included patient and epidemiologic risk factors, causative fungal organism, surgical management, antimicrobial regimen, recurrence rates, and outcomes...
December 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28009644/imaging-of-nontraumatic-thoracic-emergencies
#9
Lauran Stöger, Cornelia Schaefer-Prokop, Bram H J Geurts
PURPOSE OF REVIEW: Acute chest symptoms form an important incentive for imaging in the emergency setting. This review discusses the radiologic features of various vascular and pulmonary diseases leading to acute respiratory distress and recent developments on important emergency radiologic examinations. RECENT FINDINGS: Recently, triple-rule-out computed tomography protocol was introduced in diagnosis of chest pain, and advancing computed tomography technology and knowledge have led to discussion on treatment of pulmonary embolism...
December 21, 2016: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28004900/current-management-of-inguinal-false-aneurysms
#10
Kim Houlind, Jørn M Jepsen, Cristian Saicu, Sten Vammen, Johnny K Christensen, Hans Ravn
False aneurysms are formed as a result of bleeding causing a hematoma to compress the surrounding tissue. The majority of false aneurysms presenting to the vascular surgeon are caused by iatrogenic injury to an artery. Although anastomotic failure occurs, a much higher number is caused by bleeding from puncture sites after percutaeous intervention. Anticoagulative medication, low patelet counts and severely calcified vessels increase the risk of forming a false aneurysm. Experienced specialists may make the diagnosis from physical examination, but ultrasound imaging is almost always needed in order to decide for a treatment strategy...
December 22, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27992070/exercise-for-haemophilia
#11
REVIEW
Karen Strike, Kathy Mulder, Rojer Michael
BACKGROUND: Haemophilia is a bleeding disorder associated with haemorrhaging into joints and muscles. Exercise is often used to aid recovery after bleeds, and to improve joint function in the presence of arthropathy. OBJECTIVES: Our objective was to systematically review the available evidence on the safety and effectiveness of exercise for people with haemophilia. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register and electronic databases PubMed, OVID-Embase, and CINAHL...
19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27990116/combined-acute-haemolytic-and-secondary-angle-closure-glaucoma-following-spontaneous-intraocular-haemorrhages-in-a-patient-on-warfarin
#12
Walter Andreatta, Stavroula Boukouvala, Atul Bansal
BACKGROUND: To report the first described case of combined haemolytic and acute angle closure glaucoma secondary to spontaneous intraocular haemorrhages in a patient on excessive anticoagulation. To the best of our knowledge, this is the first case reported in the literature presenting with raised intraocular pressure due to both mechanisms. CASE DESCRIPTION: A 90-year-old woman presented with acute pain and reduction in vision in the left eye. Her intraocular pressure (IOP) was 55 mm Hg...
September 2016: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/27988341/can-lumbosacral-orthoses-cause-trunk-muscle-weakness-a-systematic-review-of-literature
#13
REVIEW
Fatemeh Azadinia, Esmaeil Ebrahimi Takamjani, Mojtaba Kamyab, Mohamad Parnianpour, Jacek Cholewicki, Nader Maroufi
BACKGROUND: Wearing lumbosacral orthosis (LSO) is one of the most common treatments prescribed for conservative management of low back pain. While the results of randomized controlled trials suggest effectiveness of LSO in reducing pain and disability in these patients, there is a concern that prolonged use of LSO may lead to trunk muscle weakness and atrophy. PURPOSE: The present review aimed to evaluate available evidence in literature to determine whether LSO result in trunk muscle weakness and/or atrophy...
December 14, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27988260/myths-in-the-evaluation-and-management-of-ovarian-torsion
#14
Jennifer J Robertson, Brit Long, Alex Koyfman
BACKGROUND: Ovarian torsion is a rare but serious cause of pelvic pain in females. Making the diagnosis is important because misdiagnosis can lead to an ischemic ovary and subsequent infertility. OBJECTIVE: Although all emergency physicians are aware of ovarian torsion, there are several myths regarding its epidemiology, diagnosis, and treatment. This article attempts to review some of these myths to improve emergency diagnosis and evaluation. DISCUSSION: Ovarian torsion is not an easy diagnosis to make and it is commonly missed...
December 14, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27987609/endovascular-management-of-chronic-total-occlusions-of-the-inferior-vena-cava-and-iliac-veins
#15
Erin H Murphy, Blake Johns, Elliot Varney, Seshadri Raju
OBJECTIVE: Percutaneous recanalization and stenting is currently the standard of care for symptomatic chronic total occlusions (CTOs) of the iliofemoral veins. CTO lesions involving the inferior vena cava (IVC) present a more complex patient subset. In this series we describe our single-center experience with endovascular recanalization of symptomatic occlusions of the IVC. METHODS: Patients were evaluated with duplex ultrasound imaging, venous function tests, and venography before intervention...
January 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27956826/nonmotor-gastrointestinal-disorders-in-older-patients-with-parkinson-s-disease-is-there-hope
#16
Doina Georgescu, Oana Elena Ancusa, Liviu Andrei Georgescu, Ioana Ionita, Daniela Reisz
Despite the fact that nonmotor symptoms (NMS) like gastrointestinal (GI) complaints are frequently reported in Parkinson's disease (PD), no therapeutic guidelines are available. This study aimed to manage some lower GI-NMS in a group of patients with PD. A total of 40 patients (17 males, 23 females; mean age 76.05±2.09 years) were randomly selected for this study. Patients were confirmed to have PD (modified Hoehn-Yars scale: 2.075±0.4) who had undergone levodopa or dopamine agonist treatment. In the non-motor symptoms questionnaire (NMS-Quest), regarding GI complaints, the following were recorded: abdominal pain, bloating, and constipation of mild-to-moderate severity...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27956404/percutaneous-therapies-for-peripheral-artery-disease
#17
Mehdi H Shishehbor, Michael R Jaff
Percutaneous therapies for peripheral artery disease continue to evolve with new techniques and devices. Although guidelines-recommended therapies have impacted cardiovascular morbidity and mortality, endovascular interventions have been shown to reduce limb pain, improve quality of life, and prolong walking distance for those with claudication and to reduce amputation rates among those with critical limb ischemia. Novel devices such as drug-eluting stents and drug-coated balloons have improved patency for moderate-length lesions, whereas others allow treatment of heavily calcified and tortuous segments...
December 13, 2016: Circulation
https://www.readbyqxmd.com/read/27942784/-introduction-of-prehospital-emergency-ultrasound-into-an-emergency-medical-service-area
#18
C Weilbach, A Kobiella, N Rahe-Meyer, K Johanning
BACKGROUND: Emergency ultrasound as part of the provision of emergency medical services using mobile devices offers great benefits regarding to some important questions related to the management of critically ill and injured patients in the prehospital situation where diagnostic resources are limited. The aim of this study is to determine whether the comprehensive introduction of prehospital emergency ultrasound examinations into a German Emergency Medical Services ("rescue services") area is both feasible and beneficial for patients...
December 9, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27938945/complications-after-fine-needle-aspiration-cytology-a-retrospective-study-of-7449-consecutive-thyroid-nodules
#19
C Cappelli, I Pirola, B Agosti, A Tironi, E Gandossi, P Incardona, F Marini, A Guerini, M Castellano
Although fine-needle aspiration (FNA) cytology of thyroid nodules is invasive, it is simple, reliable, safe, and well-accepted by patients. Local pain and minor haematomas are the most common complications, and serious ones are rare. We report the complications associated with ultrasound-guided FNA of 7449 thyroid nodules in a series of 6323 patients (5121 women and 1202 men) treated between January 2007 and March 2016 at our institution. We reviewed their medical and imaging records, and recorded the number and type of complications, time of detection, time to recovery, management, and permanent consequences...
December 6, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27932439/management-of-splenic-ectopic-pregnancy-presenting-with-massive-haemoperitoneum
#20
Alissa Greenbaum, Richard Miskimins, Brittany Coffman, Jasmeet Paul
Abdominal ectopic pregnancy (EP) accounts for only 1.3% of EPs and occurs when a fertilised ovum implants in an extrapelvic peritoneal location. Primary splenic pregnancy is a rare type of abdominal EP, with only 16 cases previously reported in the literature. Early diagnosis is essential as delay in treatment carries significant potential for morbidity and mortality. We present the case of a 27-year-old woman presenting with left upper quadrant abdominal pain, elevated human chorionic gonadotropin levels, absence of intrauterine gestational sac and massive haemoperitoneum on transvaginal ultrasound...
December 8, 2016: BMJ Case Reports
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