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https://www.readbyqxmd.com/read/29222573/incidence-and-causes-of-overdiagnosis-of-optic-neuritis
#1
Leanne Stunkel, Nathan H Kung, Bradley Wilson, Collin M McClelland, Gregory P Van Stavern
Importance: Diagnostic error is an important source of medical error. Overdiagnosis of optic neuritis may prompt unnecessary and costly diagnostic tests, procedures, and treatments. Objective: To assess the incidence of and characterize factors contributing to overdiagnosis of acute optic neuritis. Design, Setting, and Participants: In this retrospective clinic-based cross-sectional study of new patient encounters, 122 patients referred for acute optic neuritis at a university-based Midwestern neuro-ophthalmology clinic between January 2014 and October 2016 were studied...
December 7, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29222405/multiple-weekly-dalbavancin-dosing-for-the-treatment-of-native-vertebral-osteomyelitis-caused-by-methicillin-resistant-staphylococcus-aureus-a-case-report
#2
Thamer A Almangour, Valerie Fletcher, Mohammed Alessa, Abdullah A Alhifany, Deanne Tabb
BACKGROUND Native vertebral osteomyelitis (NVO) is a common form of hematogenous osteomyelitis, with Staphylococcus aureus (S. aureus) being the most commonly isolated organism. Dalbavancin is approved by the US Food and Drug Administration (FDA) for the treatment of acute bacterial skin and skin structure infections (ABSSSI) and has a sufficiently promising pharmacokinetic and pharmacodynamic profile to be considered for the treatment of vertebral osteomyelitis. We describe here what is probably the first reported case of using multiple weekly dalbavancin to treat a complicated methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and vertebral osteomyelitis...
December 9, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29222304/targeting-novel-mechanisms-of-pain-in-sickle-cell-disease
#3
REVIEW
Huy Tran, Mihir Gupta, Kalpna Gupta
Patients with sickle cell disease (SCD) suffer from intense pain that can start during infancy and increase in severity throughout life, leading to hospitalization and poor quality of life. A unique feature of SCD is vaso-occlusive crises (VOCs) characterized by episodic, recurrent, and unpredictable episodes of acute pain. Microvascular obstruction during a VOC leads to impaired oxygen supply to the periphery and ischemia reperfusion injury, inflammation, oxidative stress, and endothelial dysfunction, all of which may perpetuate a noxious microenvironment leading to pain...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222302/pain-measurement-tools-in-sickle-cell-disease-where-are-we-now
#4
REVIEW
Deepika S Darbari, Amanda M Brandow
Pain is a complex multidimensional experience and the most common morbidity in patients with sickle cell disease (SCD). Tools to assess pain can be of use not only to guide pain treatment but also to provide insight into underlying pain neurobiology. Mechanisms of pain in SCD are multifactorial and are not completely elucidated. Although vaso-occlusion of microcirculation by sickled red cells is believed to be the underlying mechanism of acute vaso-occlusive pain, mechanisms for chronic pain and the transition from acute to chronic pain are under investigation...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222301/optimizing-the-care-model-for-an-uncomplicated-acute-pain-episode-in-sickle-cell-disease
#5
REVIEW
Paul Telfer, Banu Kaya
The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222286/improving-emergency-department-based-care-of-sickle-cell-pain
#6
REVIEW
Jeffrey A Glassberg
Pain is the leading cause of emergency department (ED) visits for individuals living with sickle cell disease (SCD). The care that is delivered in the ED is often cited by patients with SCD as the area of health care in greatest need of improvement. In 2014, the National Heart, Lung, and Blood Institute released guidelines for the care of SCD, including recommendations for the management of acute sickle cell pain in the ED. These guidelines provide a framework to understand the elements of ideal emergency sickle cell pain care; however, they do not provide guidance on barriers and facilitators to achieving these ideals in the complex system of the ED...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222255/non-chemotherapy-drug-induced-neutropenia-key-points-to-manage-the-challenges
#7
REVIEW
Brian R Curtis
Non-chemotherapy idiosyncratic drug-induced neutropenia (IDIN) is a relatively rare but potentially fatal disorder that occurs in susceptible individuals, with an incidence of 2.4 to 15.4 cases per million population. Affected patients typically experience severe neutropenia within several weeks to several months after first exposure to a drug, and mortality is ∼5%. The drugs most frequently associated with IDIN include metamizole, clozapine, sulfasalazine, thiamazole, carbimazole, amoxicillin, cotrimoxazole, ticlopidine, and valganciclovir...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222221/acute-pancreatitis-following-oesophagogastroduodenoscopy
#8
Nnamdi Arinze Nwafo
Acute pancreatitis is a well-recognised complication of endoscopic procedures like endoscopic retrograde cholangiopancreatography but not oesophagogastroduodenoscopy (OGD). I report a case of a 33-year-old woman, admitted with severe epigastric pain and vomiting 2 hours after an elective OGD for evaluation of chronic gastrointestinal symptoms. Pancreatitis was diagnosed on the basis of elevated lipase (40 790 U/L; normal 11-82) and findings on imaging studies. Other common causes of acute pancreatitis such as gallstones, alcohol and medications were ruled out...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29221844/gabapentin-as-an-adjuvant-therapy-for-prevention-of-acute-phantom-limb-pain-in-pediatric-patients-undergoing-amputation-for-malignant-bone-tumors-a-prospective-double-blind-randomized-controlled-trial
#9
Xiandi Wang, Ying Yi, Dingbo Tang, Yi Chen, Yanhua Jiang, Jun Peng, Jiwei Xiao
CONTEXT: Gabapentin is reported to have an analgesic effect of reducing phantom-limb pain(PLP) in adult patients. There's no study on preoperative use of gabapentin in pediatric population in term of PLP prevention. OBJECTIVE: To determine whether gabapentin could be used as an adjuvant agent of opioid-based pain control to lower the rate of phantom-limb pain in pediatric patients undergoing amputation for malignant bone tumors in observation period of 60 days post-operatively...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29221809/acute-pain-and-peripheral-sensitization-following-cautery-disbudding-in-1-and-4-week-old-calves
#10
Mirra Alessandro, Spadavecchia Claudia, Bruckmaier Rupert, Gutzwiller Andreas, Casoni Daniela
Acute pain and peripheral sensitization development after cautery disbudding was investigated in 33 calves administered preventive multimodal analgesia. The animals were assigned randomly to three groups: 1) Group SH (Control), undergoing sham disbudding at 1 and 4weeks of age; 2) Group ED (Early Disbudding), undergoing disbudding at 1week of age and sham disbudding at 4weeks of age; 3) Group LD (Late Disbudding), undergoing sham disbudding at 1week of age and disbudding at 4weeks of age. Physiological parameters (heart rate, respiratory rate, rectal temperature, invasive blood pressure, cortisol, β-endorphin, interleukin-1β, interleukin-6, tumor necrosis factor-α and haptoglobin plasmatic concentration), local variables (tactile sensitivity score, pressure pain thresholds and horn temperature), behavior and pain scores [multidimensional pain scale and visual analogue scale (VAS)] were assessed at baseline and at several pre-determined time points until 24h after disbudding...
December 5, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/29221631/a-population-based-evaluation-of-the-natural-history-of-chronic-pancreatitis
#11
Jorge D Machicado, Suresh T Chari, Lawrence Timmons, Gong Tang, Dhiraj Yadav
BACKGROUND: Based on reports from tertiary care centers, chronic pancreatitis (CP) is considered to be a painful and debilitating disease frequently requiring invasive interventions. Our primary aim was to assess the natural course of CP in a population-based cohort using endoscopic and surgical interventions as surrogates for disease aggressiveness. METHODS: We identified all patients (n = 89, alcoholic [ACP = 46], non-alcoholic [NACP] = 43) with newly diagnosed definite CP from Olmsted County, Minnesota between 1977 and 2006...
November 24, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29221351/extracorporeal-membrane-oxygenation-system-as-a-bridge-to-reparative-surgery-in-ventricular-septal-defect-complicating-acute-inferoposterior-myocardial-infarction
#12
Jose Rozado, Isaac Pascual, Pablo Avanzas, Daniel Hernandez-Vaquero, Ruben Alvarez, Rocio Díaz, Beatriz Díaz, María Martín, Amelia Carro, Guillermo Muñiz, Jacobo Silva, Cesar Moris
Post-infarction ventricular septal defect (VSD) is a rare but potentially lethal complication of acute myocardial infarction. Medical management is usually futile, so definitive surgery remains the treatment of choice but the risk surgery is very high and the optimal timing for surgery is still under debate. A 55-year-old man with no previous medical history attended the emergency-room for 12 h evolution of oppressive chest pain and strong anginal pain 7 days ago. On physical examination, blood pressure was 96/70 mmHg, pansystolic murmur over left sternal border without pulmonary crackles...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29220303/locally-aggressive-connective-tissue-tumors
#13
Mrinal M Gounder, David M Thomas, William D Tap
In this review, we highlight the complexities of the natural history, biology, and clinical management of three intermediate connective tissue tumors: desmoid tumor (DT) or aggressive fibromatosis, tenosynovial giant cell tumor (TGCT) or diffuse-type pigmented villonodular synovitis (dtPVNS), and giant cell tumor of bone (GCTB). Intermediate histologies include tumors of both soft tissue and bone origin and are locally aggressive and rarely metastatic. Some common aspects to these tumors are that they can be locally infiltrative and/or impinge on critical organs, which leads to disfigurement, pain, loss of function and mobility, neurovascular compromise, and occasionally life-threatening consequences, such as mesenteric, bowel, ureteral, and/or bladder obstruction...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29219892/toxicity-of-vincristine-combined-with-posaconazole-in-children-with-acute-lymphoblastic-leukemia
#14
Esra Pekpak, Talia İleri, Elif İnce, Mehmet Ertem, Zümrüt Uysal
BACKGROUND: Vincristine (VCR) is one of the main drugs of acute lymphoblastic leukemia (ALL) treatment. Azole antifungal medications are used for treatment or prophylaxis of invasive fungal infections in acute leukemia. Coadministration of these drugs increases the risk of VCR toxicity. OBSERVATIONS: We presented a girl with ALL using posaconazole prophylaxis. She developed VCR toxicity that included tubulopathy, high blood pressure, neuropathic pain, difficulty walking, diffuse muscular weakness, constipation, abdominal pain...
December 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29219835/answer-to-photo-quiz-a-52-year-old-oncology-patient-with-acute-severe-abdominal-pain
#15
(no author information available yet)
No abstract text is available yet for this article.
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29219834/a-52-year-old-oncology-patient-with-acute-severe-abdominal-pain
#16
L Keikes, H Klümpen, H W M van Laarhoven
No abstract text is available yet for this article.
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29218817/impact-of-a-shared-decision-making-intervention-on-healthcare-utilization-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#17
Jason T Schaffer, Erik P Hess, Judd E Hollander, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Jonathan Inselman, Jeph Herrin, Victor M Montori, Nilay D Shah
BACKGROUND: Patients at low risk for acute coronary syndrome (ACS) are frequently admitted for observation and cardiac testing, resulting in substantial burden and cost to the patient and the healthcare system. OBJECTIVES: The purpose of this investigation was to measure the effect of the Chest Pain Choice decision aid (CPC) on overall healthcare utilization as well as utilization of specific services both during the index emergency department visit and in the subsequent 45 days...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29218798/high-risk-clinical-features-for-acute-aortic-dissection-a-case-control-study
#18
Robert Ohle, Justin Um, Omar Anjum, Helena Bleeker, Lindy Luo, George Wells, Jeffrey J Perry
BACKGROUND: Acute aortic dissection (AAD) is a rare condition with a high mortality that is often missed. The objective of our study was to assess the diagnostic accuracy of clinical and laboratory findings for AAD, in confirmed cases of AAD and a low risk control group. METHODS: Historical matched case-control study: participants were adults >18 years old presenting to two tertiary care emergency departments (ED) or one regional cardiac referral center. CASES: new ED or in-hospital diagnosis of non-traumatic AAD confirmed by computed tomography or echocardiography...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29218466/acute-herpes-zoster-and-post-herpetic-neuralgia-in-primary-care-a-study-of-diagnosis-treatment-and-cost
#19
Brendan Crosbie, Sinead Lucey, Lesley Tilson, Lisa Domegan, Jennifer Kieran
Acute herpes zoster and its complication post herpetic neuralgia represent a significant challenge to primary care physicians in their care of an ageing population of patients. This was a cross-sectional observational study by means of a quantitative survey of 1,000 general practitioners registered in Ireland exploring the frequency of diagnosis, methods of treatment and cost of AHZ and PHN in primary care. We recorded an 18% response rate (n = 184) with an 83% completion rate (n = 152/184). 80% of cases of AHZ occurred in patients aged 50 years or more with 81% of study participants encountering cases at a rate of 1-3 patients per month...
December 7, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29218132/portal-vein-thrombosis-in-adult-omani-patients-a-retrospective-cohort-study
#20
Khalid Al Hashmi, Lamya Al Aamri, Sulayma Al Lamki, Anil Pathare
OBJECTIVES: We sought to study the occurrence of portal vein thrombosis (PVT) in adult Omani patients. Methods: We conducted a retrospective cross-sectional study in patients diagnosed with PVT, which was confirmed by radiological imaging, from two tertiary hospitals over a 10-year period. Results: Amongst the 39 patients enrolled in the study, 15 (38.4%) had cirrhosis of the liver, and 24 (61.5%) were non-cirrhotic. In the non-cirrhotic PVT patients, 15 (62.5%) had acute PVT, whereas nine (37...
November 2017: Oman Medical Journal
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