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Ultrasound and pain management

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https://www.readbyqxmd.com/read/29153007/ultrasound-guided-hyaluronic-acid-injection-for-the-management-of-morton-s-neuroma
#1
Kang Lee, Il-Yeong Hwang, Chang Hyun Ryu, Jae Woo Lee, Seung Woo Kang
BACKGROUND: Morton's neuroma is one of the common causes of forefoot pain. In the present study, hyaluronic acid injection was performed on patients to determine the efficacy and adverse effects of hyaluronic acid in management of Morton's neuroma. METHODS: Eighty-three patients with Morton's neuroma in their third intermetatarsal space with definite Mulder's click were included in the study. Those with severe forefoot deformities such as forefoot cavus or hallux valgus on plain X-rays were excluded...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29152410/ultrasound-triggered-local-anaesthesia
#2
Alina Y Rwei, Juan L Paris, Bruce Wang, Weiping Wang, Christopher D Axon, María Vallet-Regí, Robert Langer, Daniel S Kohane
On-demand relief of local pain would allow patients to control the timing, intensity and duration of nerve block in a safe and non-invasive manner. Ultrasound would be a suitable trigger for such a system, as it is in common clinical use and can penetrate deeply into the body. Here, we demonstrate that ultrasound-triggered delivery of an anaesthetic from liposomes allows the timing, intensity and duration of nerve block to be controlled by ultrasound parameters. On insonation, the encapsulated sonosensitizer protoporphyrin IX produces reactive oxygen species that react with the liposomal membrane, leading to the release of the potent local anaesthetic tetrodotoxin...
2017: Nature biomedical engineering
https://www.readbyqxmd.com/read/29146647/initial-non-operative-management-of-uncomplicated-appendicitis-in-children-a-protocol-for-a-multicentre-randomised-controlled-trial-apac-trial
#3
Max Knaapen, Johanna H van der Lee, Roel Bakx, Sarah-May L The, Ernst W E van Heurn, Hugo A Heij, Ramon R Gorter
INTRODUCTION: Based on epidemiological, immunological and pathology data, the idea that appendicitis is not necessarily a progressive disease is gaining ground. Two types are distinguished: simple and complicated appendicitis. Non-operative treatment (NOT) of children with simple appendicitis has been investigated in several small studies. So far, it is deemed safe. However, its effectiveness and effect on quality of life (QoL) have yet to be established in an adequately powered randomised trial...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132523/pancreatitis-and-pancreatic-cancer
#4
REVIEW
Anne Walling, Robert Freelove
Most cases of acute pancreatitis are related to gallstones. More than 80% resolve within a few days. The diagnosis is based on upper abdominal pain, elevated lipase and/or amylase, and transabdominal ultrasound findings. Management requires early aggressive hydration, pain control, nutritional support, and monitoring for progression. Patients who develop hypovolemia, systemic inflammatory response, pancreatic necrosis, and organ failure have high mortality, risk of recurrence, and progression to chronic pancreatitis (CP)...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132339/sequential-e2-levels-not-ovarian-maximal-diameter-estimates-were-correlated-with-outcome-of-cetrotide-therapy-for-management-of-women-at-high-risk-of-ovarian-hyperstimulation-syndrome-a-randomized-controlled-study
#5
Khalid M Salama, Hesham M Abo Ragab, Mohammed F El Sherbiny, Ali A Morsi, Ibrahim I Souidan
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) is an important condition with considerable morbidity and a small risk of mortality and most commonly results as an iatrogenic condition following follicular stimulation of the ovaries. We aimed to evaluate safety and efficacy of 3-day cetrotide therapy started on day of oocyte retrieval (Day-0) in women at high-risk for development of ovarian hyperstimulation syndrome (OHSS) after GnRH agonist induction protocol. METHODS: Forty-eight women fulfilling inclusion criteria underwent ultrasound scanning for maximal ovarian diameter (MOD) estimation and ascites grading...
November 13, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/29123624/state-of-education-regarding-ultrasound-guided-interventions-during-pain-fellowships-in-korea-a-survey-of-recent-fellows
#6
Hyung Tae Kim, Sae Young Kim, Gyung Jo Byun, Byung Chul Shin, Jin Young Lee, Eun Joo Choi, Jong Bum Choi, Ji Hee Hong, Seung Won Choi, Yeon Dong Kim
Background: Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods: We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017...
October 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/29118532/transperitoneal-laparoscopic-repair-of-retrocaval-ureter-our-experience-and-review-of-literature
#7
Ashwin S Tamhankar, Abhishek J Savalia, Ajit S Sawant, Prakash W Pawar, Gaurav V Kasat, Sunil R Patil
Context and Aim: Retrocaval ureter (RCU), also known as circumcaval ureter, occurs due to anomalous development of inferior vena cava (IVC) and not ureter. The surgical approach for this entity has shifted from open to laparoscopic and robotic surgery. This is a relatively new line of management with very few case reports. Herein, we describe the etiopathology, our experience with six cases of transperitoneal laparoscopic repair of RCU operated at tertiary care center in India and have reviewed different management options...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29114418/stop-being-so-sensitive-an-exceptionally-rare-report-of-ustekinumab-induced-sub-acute-hypersensitivity-pneumonitis
#8
Azka Ali, Jason Chertoff, Christopher Harden, Dara Wakefield, James Wynne
Hypersensitivity pneumonitis (HSP) is a rare syndrome characterised by granulomatous inflammatory lung disease due to repeated sensitisation from a specific antigen. We present the case of a 61-year old male veteran with a history of nodular eczema who presented with 2 weeks of progressive dyspnoea on exertion and pleuritic chest pain. The patient was started on ustekinumab 5 weeks prior to presentation. Initial workup revealed ground-glass opacities on computed tomography (CT) scan of the chest. Cardiac workup was unrevealing with a normal myocardial perfusion stress test...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29112915/acute-abdomen-secondary-to-a-spontaneous-perforation-of-the-biliary-tract-a-rare-complication-of-choledocholithiasis
#9
G A Gómez-Torres, F M Rodríguez-Navarro, C R López-Lizárraga, C A Bautista-López, O S Ortega-García, G Becerra-Navarro, A Águila-Barragán, C F Ploneda-Valencia
INTRODUCTION: The spontaneous perforation of the biliary tract (SPBT) is an extremely rare cause of peritonitis, which was first described by Freeland in 1982, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis, which was treated with ultrasound-guided drainage and ERCP. CASE REPORT: A 51-year-old male was admitted to the emergency room for 15-day evolution jaundice, localized pain in the right flank and hypochondrium of 3days...
October 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29110807/psychobiological-correlates-of-vaginismus-an-exploratory-analysis
#10
Elisa Maseroli, Irene Scavello, Sarah Cipriani, Manuela Palma, Massimiliano Fambrini, Giovanni Corona, Edoardo Mannucci, Mario Maggi, Linda Vignozzi
BACKGROUND: Evidence concerning the determinants of vaginismus (V), in particular medical conditions, is inconclusive. AIM: To investigate, in a cohort of subjects consulting for female sexual dysfunction, whether there is a difference in medical and psychosocial parameters between women with V and women with other sexual complaints. METHODS: A series of 255 women attending our clinic for female sexual dysfunction was consecutively recruited...
November 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29104834/a-case-of-spontaneous-isolated-celiac-artery-dissection-with-pseudoaneurysm-formation
#11
John Kim, Lamar H Moree, Michael J Muehlberger
Spontaneous isolated celiac artery dissection is a rare disease and patients without evidence of significant complications often resolve with medical therapy alone; however, the extension of the dissection can lead to more serious complications including aneurysmal dilatation, complete occlusion, and rupture of a visceral artery. In these patients, optimal management has not yet been clearly defined and treatment primarily depends on clinical presentation and lesions identified on imaging studies. This case report demonstrates the conservative management of spontaneous celiac artery dissection...
August 27, 2017: Curēus
https://www.readbyqxmd.com/read/29102985/study-protocol-for-a-randomised-controlled-trial-of-ultrasound-guided-pulsed-radiofrequency-of-the-genicular-nerves-in-the-treatment-of-patients-with-osteoarthritis-knee-pain
#12
Javier Mata, Pedro Valentí, Beatriz Hernández, Bartolome Mir, Jose Luis Aguilar
INTRODUCTION: The goals for the management of patients with osteoarthritis (OA) of the knee are to control pain and to minimise disability. Because the number of patients will increase as the population ages, alternative approaches to alleviate their joint pain other than conventional treatments are necessary. The purpose of this article is to present a refined protocol to determine if there is long-term improvement in pain and function after ultrasound-guided pulsed radiofrequency treatment of the genicular nerves (GNs) in patients with chronic painful knee OA...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29095397/correlation-of-mri-to-arthroscopy-in-the-elbow-thrower-s-elbow-and-ulnar-collateral-ligament-injury
#13
Michael C Ciccotti, Justin D Stull, Patrick S Buckley, Steven B Cohen
One cannot overstate the importance of a thorough history and physical examination, supplemented with directed imaging, to help pinpoint the exact cause of the athlete's elbow pain. Although plain radiographs should not be overlooked, advanced imaging plays a critical role in diagnosis and management of pathology in the thrower's elbow, including computed tomography, magnetic resonance imaging, and stress ultrasound. By judiciously combining these elements, the clinician can appropriately manage these injuries in order to successfully return the athlete to their preinjury level of play...
December 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/29092966/use-of-emergency-department-point-of-care-ultrasound-in-a-case-of-cholecystitis
#14
Nicolas Lim, Aileen McCabe, John Cronin
A 54-year-old man presented with severe right upper quadrant (RUQ) abdominal pain. He denied any infective symptoms. On clinical examination, he was afebrile and anicteric. His abdomen was soft with tenderness elicited on the RUQ. A point-of-care ultrasound in the emergency department demonstrated a distended gallbladder with a thickened wall and an impacted large gallstone at the neck of the gallbladder. Furthermore, the point-of-care ultrasound also identified a highly reflective echo from the anterior surface of the gallstone and marked posterior acoustic shadowing...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29090103/unilateral-atraumatic-expulsion-of-an-ectopic-pregnancy-in-a-case-of-bilateral-ectopic-pregnancy
#15
Victoria Sampson, Oluremi Mogekwu, Ammar Ahmed, Farida Bano
Ectopic pregnancy occurs in 1-2% of pregnancies. The fallopian tube is the most common site; however, bilateral tubal ectopic pregnancy is an extremely rare phenomenon, seen in approximately 1/200,000 pregnancies. It is usually the result of assisted reproductive techniques (ART). Ultrasound (USS) and serial beta-hCG levels have shown poor efficacy for accurate diagnosis. Laparoscopy is the diagnostic gold standard. The majority of cases are managed surgically with bilateral salpingectomy. A 26-year-old female presented to our early pregnancy unit with pain and vaginal bleeding at 5-week gestation after IVF...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29082325/endoscopic-treatment-of-intrauterine-device-migration-into-the-bladder-with-stone-formation
#16
Masayuki Sano, Kaoru Nemoto, Takafumi Miura, Yasutomo Suzuki
Background: An intrauterine device is commonly used for contraception globally. Although intrauterine device placement is an effective and safe method of contraception, migration into the bladder with stone formation is a rare and serious complication. The management approaches for an intrauterine device embedded in the bladder include endoscopic procedures and open surgical removal. In this study, we report the case of a patient with recurrent urinary tract infection associated with intrauterine device migration and urolithiasis, who successfully underwent endoscopic treatment combined with laser fragmentation...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29081016/a-review-of-imaging-modalities-used-in-the-diagnosis-and-management-of-scrotal-trauma
#17
REVIEW
Alexis Wang, Ian Stormont, M Minhaj Siddiqui
Genitourinary tract injuries account for 3 to 10% of trauma patients, and scrotal trauma is particularly prevalent in males 10 to 30 years of age. Prompt diagnosis and timely surgical intervention are essential to prevent future complications of infertility, delayed orchiectomy, infection, and testicular atrophy. While clinical examination provides valuable information, it may be inconclusive due to soft tissue swelling and difficult to perform due to testicular pain with palpation. Conversely, testicular rupture does not always present with pain or tenderness...
October 28, 2017: Current Urology Reports
https://www.readbyqxmd.com/read/29076746/predicting-poor-outcome-from-simple-ankle-injuries-a-prospective-cohort-study
#18
Stuart A Bullock, Georgina M Allen, Marion S Watson, David J Wilson
BACKGROUND: Sprained ankles are common and when there are no signs or evidence of a fracture, conventional management is conservative. At present, there are no clinical markers to identify those that may develop persisting instability and disability that would require rehabilitation or surgery. OBJECTIVES: To investigate the nature and extent of soft tissue ankle injuries, and to consider whether the anatomical severity of injury can predict functional outcome. METHODS: Patients attending a local Accident and Emergency Department in Oxford with an acute ankle injury with no clinical requirement for radiographs, or where radiographs were normal, were invited into the study...
November 9, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29072372/misoprostol-treatment-vs-expectant-management-in-early-non-viable-pregnancy-in-women-with-vaginal-bleeding-a-pragmatic-randomized-controlled-trial
#19
A Fernlund, L Jokubkiene, P Sladkevicius, L Valentin
OBJECTIVES: To compare vaginal misoprostol treatment with expectant management in early non-viable pregnancies with vaginal bleeding with regard to complete evacuation of the uterine cavity within 10 days. METHODS: Parallel randomized controlled, open label, trial conducted in Skåne university hospital, Sweden. Patients with anembryonic pregnancy or early fetal demise (crown-rump length <33mm) and vaginal bleeding were randomly allocated to either expectant management or single dose 800μg of misoprostol vaginally...
October 26, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29067082/effectiveness-of-core-stabilization-exercises-and-routine-exercise-therapy-in-management-of-pain-in-chronic-non-specific-low-back-pain-a-randomized-controlled-clinical-trial
#20
Muhammad Waseem Akhtar, Hossein Karimi, Syed Amir Gilani
BACKGROUND & OBJECTIVE: Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain...
July 2017: Pakistan Journal of Medical Sciences Quarterly
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