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https://www.readbyqxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#1
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
March 3, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28330885/dientamoeba-fragilis-a-commensal-in-children-in-danish-day-care-centers
#2
Pikka Jokelainen, Betina Hebbelstrup Jensen, Bente Utoft Andreassen, Andreas Munk Petersen, Dennis Röser, Karen A Krogfelt, Henrik V Nielsen, Christen R Stensvold
Dientamoeba fragilis is an intestinal protozoan of debated clinical significance. Here, we present cross-sectional and longitudinal observations on D. fragilis in children aged 0-6 years from a 1-year multi-day-care-center cohort study set in Copenhagen, Denmark. The inclusion period for the cohort was 2009-2012. Stool samples collected from the children were accompanied by questionnaires completed by the parents or guardians of the children. Using real-time PCR, D. fragilis was detected in the first stool sample from 97 (68...
March 22, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28330700/the-effect-of-kinesio-taping-on-back-pain-in-patients-with-lenke-type-1-adolescent-idiopathic-scoliosis-a-randomized-controlled-trial
#3
Yunus Atici, Canan Gonen Aydin, Aysegul Atici, Mehmet Ozbey Buyukkuscu, Yavuz Arikan, Mehmet Bulent Balioglu
PURPOSE: This study investigated the short-term effects of KT on back pain (BP) in patients with Lenke Type 1 adolescent idiopathic scoliosis (AIS). METHODS: We chosen Lenke Type 1 scoliosis who have had only back pain (the localization of the pain: the only in the apical convex edge). Forty patients suffering from BP with Lenke Type 1 AIS were randomly separated into two groups, Group 1 (20 patients) and Group 2 (20 patients). Group 1 was given KT with tension and home exercises and Group 2 was given KT without tension and home exercises...
March 19, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28330634/epidemiology-of-pain-in-people-with-dementia-living-in-care-homes-longitudinal-course-prevalence-and-treatment-implications
#4
Anto P Rajkumar, Clive Ballard, Jane Fossey, Martin Orrell, Esme Moniz-Cook, Robert T Woods, Joanna Murray, Rhiannon Whitaker, Jane Stafford, Martin Knapp, Renee Romeo, Barbara Woodward-Carlton, Zunera Khan, Ingelin Testad, Anne Corbett
INTRODUCTION: Knowledge regarding the longitudinal course, impact, or treatment implications of pain in people with dementia living in care homes is very limited. METHODS: We investigated the people with dementia living in 67 care homes in London and Buckinghamshire, United Kingdom. Pain, dementia severity, neuropsychiatric symptoms, depression, agitation, and quality-of-life were measured using appropriate instruments at baseline (N = 967) and after 9 months (n = 629)...
March 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#5
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323586/home-cervical-traction-to-reduce-neck-pain-in-fighter-pilots
#6
Eric M Chumbley, Nicole O'Hair, Adrienne Stolfi, Christopher Lienesch, James C McEachen, Bruce A Wright
INTRODUCTION: Most fighter pilots report cervical pain during their careers. Recommendations for remediation lack evidence. We sought to determine whether regular use of a home cervical traction device could decrease reported cervical pain in F-15C pilots. METHODS: An institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, controlled crossover study was undertaken with 21 male F-15C fighter pilots between February and June 2015...
December 1, 2016: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28322241/leisure-time-physical-activity-among-older-adults-with-long-term-spinal-cord-injury
#7
S Jörgensen, K A Martin Ginis, J Lexell
STUDY DESIGN: Cross-sectional. OBJECTIVES: To describe participation in leisure time physical activity (LTPA) (amount, intensity and type) among older adults with long-term spinal cord injury (SCI), and to investigate the associations with sociodemographics, injury characteristics and secondary health conditions (SHCs). SETTING: Home settings in southern Sweden. METHODS: Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS)...
March 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28318848/randomized-controlled-trial-of-supervised-physiotherapy-versus-a-home-exercise-program-after-hydrodilatation-for-the-management-of-primary-frozen-shoulder
#8
Paul M Robinson, Jennie Norris, Christopher P Roberts
HYPOTHESIS AND BACKGROUND: Hydrodilatation and physiotherapy are commonly used treatments for primary frozen shoulder. Little is known about the optimal form of physiotherapy. This study reports a randomized controlled trial comparing 2 forms of physiotherapy after hydrodilatation. The null hypothesis was that there would be no difference between the 2 groups at 1 year as measured by the Oxford Shoulder Score (OSS). METHODS: We randomized 41 patients undergoing hydrodilatation for primary frozen shoulder into 2 treatment groups: group 1 (n = 20) underwent supervised physiotherapy in addition to a home exercise program, and group 2 (n = 21) followed a self-directed home exercise program in isolation...
March 15, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28318437/case-240-meckel-diverticulitis
#9
R Ashley Milam, Ricardo B Fonseca
History A previously healthy 28-year-old man developed right lower quadrant pain while traveling. The pain progressed over the course of 2-3 days, and his family took him to a local emergency department. He was found to have an elevated white blood cell count of 12.2 × 10(9)/L (reference range, [3.9-10.3] × 10(9)/L), with a predominance of neutrophils. Contrast material-enhanced computed tomography (CT) of the abdomen and pelvis was performed, and findings were abnormal. The patient elected to leave the emergency department without undergoing treatment, and he returned home via airplane...
April 2017: Radiology
https://www.readbyqxmd.com/read/28315478/improving-palliative-care-trough-teamwork-impactt-in-nursing-homes-study-design-and-baseline-findings
#10
Helena Temkin-Greener, Susan Ladwig, Zhiqiu Ye, Sally A Norton, Dana B Mukamel
BACKGROUND: The 2014 Institute of Medicine report recommended that healthcare providers caring for individuals with advanced illness have basic palliative care competencies in communication, inter-professional collaboration, and symptom management. Nursing homes, where one in three American decedents live and die, have fallen short of these competency goals. We implemented an intervention study to examine the efficacy of nursing home-based integrated palliative care teams in improving the quality of care processes and outcomes for residents at the end of life...
March 14, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28292629/the-5-clinical-pillars-of-value-for-total-joint-arthroplasty-in-a-bundled-payment-paradigm
#11
Kelvin Kim, Richard Iorio
BACKGROUND: Our large, urban, tertiary, university-based institution reflects on its 4-year experience with Bundled Payments for Care Improvement. We will describe the importance of 5 clinical pillars that have contributed to the early success of our bundled payment initiative. We are convinced that value-based care delivered through bundled payment initiatives is the best method to optimize patient outcomes while rewarding surgeons and hospitals for adapting to the evolving healthcare reforms...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28292301/examining-the-relationship-between-therapeutic-self-care-and-adverse-events-for-home-care-clients-in-ontario-canada-a-retrospective-cohort-study
#12
Winnie Sun, Diane M Doran, Walter P Wodchis, Elizabeth Peter
BACKGROUND: In an era of a rapidly aging population who requires home care services, clients must possess or develop therapeutic self-care ability in order to manage their health conditions safely in their homes. Therapeutic self-care is the ability to take medications as prescribed and to recognize and manage symptoms that may be experienced, such as pain. The purpose of this research study was to investigate whether therapeutic self-care ability explained variation in the frequency and types of adverse events experienced by home care clients...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28291891/effect-of-inpatient-rehabilitation-vs-a-monitored-home-based-program-on-mobility-in-patients-with-total-knee-arthroplasty-the-hiho-randomized-clinical-trial
#13
Mark A Buhagiar, Justine M Naylor, Ian A Harris, Wei Xuan, Friedbert Kohler, Rachael Wright, Renee Fortunato
Importance: Formal rehabilitation programs, including inpatient programs, are often assumed to optimize recovery among patients after undergoing total knee arthroplasty. However, these programs have not been compared with any outpatient or home-based programs. Objective: To determine whether 10 days of inpatient rehabilitation followed by a monitored home-based program after total knee arthroplasty provided greater improvements than a monitored home-based program alone in mobility, function, and quality of life...
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28291658/how-do-they-get-here-does-the-method-of-transportation-impact-salvage-for-patients-with-testicular-torsion
#14
D A Weiss, N Tsarouhas, M C Carr, A Kalmus, S A Zderic
INTRODUCTION: A growing number of patients are arriving at our tertiary care center for evaluation of possible testicular torsion using ambulance or helicopter transport. In many cases the parents arrive by car before the patient arrives. Are these advanced methods of medical transport worth the expense and risk in the case of suspected testicular torsion? OBJECTIVE: We evaluated the total number of patients presenting to our emergency room for suspected testicular torsion to see if the means of transport affected testicular survival...
January 23, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28291130/making-the-pediatric-perioperative-surgical-home-come-to-life-by-leveraging-existing-health-information-technology
#15
Izabela C Leahy, Rachel Borczuk, Lynne R Ferrari
PURPOSE OF REVIEW: To design a patient data dashboard for the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital that supports care integration across the healthcare system as described by the pediatric perioperative surgical home (PPSH) initiative. RECENT FINDINGS: By using 360 Technology, patient data was automatically pulled from all available Electronic Health Record sources from 2005 to the present. The PPSH dashboard described in this report provides a guide for implementation of PPSH Clinical Care Pathways...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28285209/acute-large-bowel-pseudo-obstruction-due-to-atrophic-visceral-myopathy-a-case-report
#16
Sean M Wrenn, Charles S Parsons, Michelle Yang, Ajai K Malhotra
PURPOSE: Atrophic visceral myopathy is a pathological diagnosis characterized by atrophy of the smooth muscle layers of the viscera with intact ganglia. Rarely, it can present acutely as an intestinal pseudo-obstruction. We describe a rare case report and explore how this diagnosis can be distinguished from other forms of intestinal obstruction. CASE DESCRIPTION: A 60-year-old male with a past medical history of hypothyroidism presented to the emergency department with a two-day history of worsening abdominal distention and pain associated with nausea and vomiting...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28283110/access-delivery-and-perceived-efficacy-of-physiotherapy-and-use-of-complementary-and-alternative-therapies-by-people-with-progressive-multiple-sclerosis-in-the-united-kingdom-an-online-survey
#17
Evan Campbell, Elaine Coulter, Paul Mattison, Angus McFadyen, Linda Miller, Lorna Paul
INTRODUCTION: All people with progressive MS in the United Kingdom should have access to physiotherapy through the National Health Service (NHS). However levels of access and delivery are unknown. Furthermore there is no research on perceived efficacy of physiotherapy or the use of complementary and alternative medicine in people with progressive MS in the United Kingdom. METHODS: An online survey was carried out via the UK MS Register. Inclusion criteria were diagnosis of progressive MS, a member of UK MS Register and 18 years or older...
February 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28282796/use-of-low-level-of-continuous-heat-and-ibuprofen-as-an-adjunct-to-physical-therapy-improves-pain-relief-range-of-motion-and-the-compliance-for-home-exercise-in-patients-with-nonspecific-neck-pain-a-randomized-controlled-trial
#18
Jerrold S Petrofsky, Michael Laymon, Faris Alshammari, Iman Akef Khowailed, Haneul Lee
BACKGROUND: It has been well documented at heat reduces pain and increases healing by increasing blood flow in tissue. OBJECTIVE: The purpose of this study was to see if the use of low level continuous heat (LLCH) and Ibuprofen used as a home therapy between physical therapy sessions at a clinic resulted in better therapy outcomes in people with chronic neck pain. METHODS: Ninety-two patients with chronic nonspecific neck pain were randomly divided into 4 groups; LLCH group, LLCH with Ibuprofen (IP) group, sham LLCH with sham IP group, and controls...
March 3, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28279661/dynamic-balance-training-improves-physical-function-in-individuals-with-knee-osteoarthritis-a-pilot-randomized-controlled-trial
#19
Judit Takacs, Natasha M Krowchuk, S Jayne Garland, Mark G Carpenter, Michael A Hunt
OBJECTIVE: To examine the effect of a targeted balance training program on dynamic balance and self-reported physical function in people with medial tibiofemoral osteoarthritis (OA). DESIGN: A single-blind randomized controlled trial. SETTING: Exercise gymnasium and community dwellings. PARTICIPANTS: Forty individuals with medial compartment knee OA. INTERVENTION: Ten weeks of partially-supervised exercises targeting dynamic balance and strength performed four times per week, or no intervention (control group)...
March 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28277593/pain-management-with-adductor-canal-blockade-or-multimodal-periarticular-analgesia-in-elderly-total-knee-arthroplasty-patients
#20
Chukwuweike U Gwam, Nequesha Mohamed, Jaydev B Mistry, Melbin Thomas, Morad Chughtai, Sabahat Khan, Anton Khlopas, Michael A Mont, Ronald E Delanois
INTRODUCTION: Post-operative pain management in elderly total knee arthroplasty (TKA) patients has traditionally included opioids, epidurals, and femoral nerve blocks. Although these modalities are effective, they are often associated with adverse side effects, which may have a greater impact on this population. Alternative modalities, such as adductor canal blocks (ACB) and multimodal periarticular analgesia (MPA) have demonstrated great efficacy with a low side effect profile. However, it is unknown if one modality is advantageous over the other in the elderly...
March 9, 2017: Surgical Technology International
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