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Acute pain

Raquel Tonello, Camilla Fusi, Serena Materazzi, Ilaria M Marone, Francesco De Logu, Silvia Benemei, Muryel C Gonçalves, Elisabetta Coppi, Celio J Castro-Junior, Marcus Vinicius Gomez, Pierangelo Geppetti, Juliano Ferreira, Romina Nassini
BACKGROUND AND PURPOSE: Peptides from venomous animals have long been important tools for understanding pain mechanisms and for the discovery of pain treatments. Here, we hypothesized that Phα1β, a peptide purified from the armed spider Phoneutria nigriventer venom, produces analgesia by blocking the transient receptor potential ankyrin 1 (TRPA1) channel. EXPERIMENTAL APPROACH: Cultured rat dorsal root ganglion (DRG) neurons, human IMR90 fibroblasts or HEK293 cells expressing the human TRPA1 (hTRPA1-HEK293), TRPV1 (hTRPV1-HEK293) or TRPV4 (hTRPV4-HEK293), were used for calcium imaging and electrophysiology...
October 19, 2016: British Journal of Pharmacology
Yasmin Hakim, Anna Forbes, Momina Khan, Benjamin C Whitelaw
Chest pain with elevated serum troponin is a common clinical presentation and is normally managed as suspected myocardial infarction or acute coronary syndrome (ACS). We report a 49 year old man who presented with central chest pain sweating and breathlessness. He had a significantly elevated serum troponin I level and a subsequent angiogram showed near normal coronary arteries. He was subsequently investigated for fever and found to have a 3cm right sided adrenal mass consistent with a pheochromocytoma. After confirmation and appropriate blockade laparoscopic adrenalectomy was performed...
2016: Acute Medicine
R M Suresh, H C Lokesh, B S Harsha, Sri S Chandana
Pheochromocytoma, a neuroendocrine tumor of the adrenal medulla, arising from chromaffin cells, usually presents with the clinical triad of paroxysmal headache, profuse sweating and palpitations, associated with labile hypertension. Here, we present the case of an adult male with an unusual manifestation of pheochromocytoma in the form of acute pain abdomen with nausea and abdominal guarding, mimicking acute peritonitis. He had fluctuating blood pressure recordings. On subsequent investigation, a mass lesion in the left suprarenal area on an abdominal CT scan and a 24-hour urinary metanephrine assay confirmed the diagnosis of pheochromocytoma...
July 2016: Journal of the Association of Physicians of India
Abhinav Anand, Kruthi Malur, Juhi Kawale, Milind Y Nadkar
We present a case of mesentric vasculitis with systemic lupus erythematosus who relapsed after high dose steroids but achieved subsequent remission after starting pulse cyclophosphamide therapy. 38 years old female who had earlier polyserositis and cerebral venous thrombosis was admitted with provisional diagnosis of SLE and developed acute abdominal pain during hospital stay. She was diagnosed as mesenteric vasculitis and initially responded to pulse methylprednisolone. However, she had relapse which subsequently responded to pulse cyclophosphamide and steroids...
July 2016: Journal of the Association of Physicians of India
D B Kadam, Sonali Salvi, Ajay Chandanwale
The World Health Organization (WHO) has coined the term expanded dengue to describe cases which do not fall into either dengue shock syndrome or dengue hemorrhagic fever. This has incorporated several atypical findings of dengue. Dengue virus has not been enlisted as a common etiological agent in several conditions like encephalitis, Guillain Barre syndrome. Moreover it is a great mimic of co-existing epidemics like Malaria, Chikungunya and Zika virus disease, which are also mosquito-borne diseases. The atypical manifestations noted in dengue can be mutisystemic and multifacetal...
July 2016: Journal of the Association of Physicians of India
James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
October 17, 2016: Surgical Endoscopy
Ji Yeon Lim, Yoon Hee Choi, Sun Hwa Lee
Epigastric pain is a common symptom in the emergency department. Most epigastric pain is not fatal, except in acute myocardial infarction, aortic dissection, and abdominal aneurysm rupture. Epigastric pain can also be the only symptom of isolated spontaneous gastric artery dissection. We report the case of a 51-year-old woman diagnosed with neurofibromatosis who initially presented with only epigastric pain. She was initially misdiagnosed with gastritis, treated conservatively, and discharged. Two hours later, she returned to the emergency department with persistent epigastric pain and rebound tenderness in the epigastric area...
June 2016: Clin Exp Emerg Med
Brendan Michael Fitzpatrick, Michael Eugene Mullins
OBJECTIVE: To evaluate intravenous lidocaine's safety and efficacy as an analgesic agent in the treatment of a variety of painful conditions presenting to the emergency department. METHODS: This case series identified seventeen patients who received lidocaine over a six month period and recorded demographic data, amount of lidocaine administered, the amount of opioid medication administered before and after lidocaine, pre- and post-lidocaine pain scores, and any qualitative descriptors of the patient's pain recorded in the record...
June 2016: Clin Exp Emerg Med
William R Fox, Deborah B Diercks
Troponins are proteins commonly found in cardiac tissue that are released during myocardial ischemia or necrosis. These troponins can be detected by assays that can then be used to guide clinical decision-making and disposition, especially if the suspected insult is related to acute coronary syndrome. Timing of troponin measurement can be important as elevations may not be detectible immediately after an insult. New assays have been designed to detect troponin con-centrations previously too low to be detected by conventional assays...
March 2016: Clin Exp Emerg Med
Seo In Lee, Jin Joo Kim, Hyuk Jun Yang, Keun Lee
Isolated spontaneous dissection of the celiac trunk is rarely diagnosed in acute abdominal pain. We present two cases of celiac trunk and splenic artery dissection with splenic infarction. Patients were successfully managed and stabilized by medical treatment. Isolated celiac trunk dissection can be fatal, therefore providers should be careful not to overlook this entity.
December 2015: Clin Exp Emerg Med
Raju Vaishya, Ahmad Tariq Azizi, Amit Kumar Agarwal, Vipul Vijay
Osgood-Schlatter disease (OSD) is a condition in which the patellar tendon insertion on the tibial tuberosity becomes inflamed. It is a well-known condition in late childhood characterized by pain and a bony prominence over the tibial tuberosity. The pain is usually exacerbated by physical activities like running, jumping, and climbing stairs. In the acute stage, the margins of the patellar tendon become blurred in radiographs due to the soft tissue swelling. After three to four months, bone fragmentation at the tibial tuberosity is viewed...
September 13, 2016: Curēus
Robert Jackson, Philip Cheng, Sarah Moreman, Nicola Davey, Lisa Owen
Constipation is a common and often overlooked problem, but it can cause serious complications for patients including pain, nausea, urinary retention, and prolonged hospital admission. There are no recognised criteria for the diagnosis of constipation in the acute hospital setting, and it is often the role of the ward doctor to identify and manage this problem. Completion and monitoring of "stool charts" by nursing and medical staff is key to proper recognition and management of constipation. A baseline study found that while charts were completed well, they were only monitored by doctors 17...
2016: BMJ Quality Improvement Reports
Varun Kumar, Santosh Sinha, Prakash Kumar, Mohammed Razi, Chandra Mohan Verma, Ramesh Thakur, Umeshwar Pandey, Rajpal Singh Bhardwaj, Mohammed Ahmad, R K Bansal, Shalini Gupta
OBJECTIVE: The primary aim of the present study was to evaluate the complications, particularly conduction blocks, subsequent morbidity and mortality, and effect of thrombolytic therapy in Indian patients with inferior wall myocardial infarction (IWMI). METHODS: This was a prospective, observational, single-center study conducted at LPS Institute of Cardiology, Kanpur, from December 2011 to May 2014. Patients who presented with typical chest pain and were subsequently diagnosed by standardized diagnostic criteria as having IWMI were enrolled...
October 12, 2016: Anatolian Journal of Cardiology
Birgit Castelein, Ann Cools, Thierry Parlevliet, Barbara Cagnie
BACKGROUND: Altered recruitment of rotator cuff and scapulothoracic muscles has been identified in patients with subacromial impingement syndrome. To date, however, the cause-consequence relationship between pain and altered muscle recruitment has not been fully unraveled. METHODS: The effect of experimental shoulder pain induced by injection of hypertonic saline in the supraspinatus on the activity of the supraspinatus, infraspinatus, subscapularis, trapezius, and serratus anterior activity was investigated during the performance of an elevation task by use of muscle functional magnetic resonance imaging in 25 healthy individuals...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Arindam Pande, Soumya Patra, Manabhanjan Jena, Rabin Chakraborty
Thirty-nine year male had a history of road traffic accident with polytrauma. At emergency room he started having chest pain with ventricular tachycardia. He was subsequentially diagnosed with right coronary artery dissection secondary to blunt trauma which is an extremely rare cause of inferior wall myocardial infarction. After some dilemmas, he was ultimately treated with intravascular ultrasound guided coronary angioplasty with stenting and had an uneventful recovery.
September 2016: Indian Heart Journal
Mayuresh Chaudhari, Sonu Sharma, Rajesh Kumar Jha, Ramandeep Singh Ahuja, Sandeep Bansal
Primary varicella infection in an immunocompetent young adult is very rare, but it has a high mortality rate due to serious complications. We report a rare association of varicella pneumonia presenting in acute respiratory distress with mild chest pain, however with electrocardiographic and biochemical markers suggestive of acute ST elevation myocardial infarction. Coronary angiography was done to exclude infarction, serum antibody titers confirmed varicella, acyclovir was started, and ARDS was successfully treated with steroid pulse therapy and mechanical ventilator support...
September 2016: Indian Heart Journal
Sunil Kr Verma
A 62-year-old male was undergoing treatment of NHL with bone marrow involvement with thrombocytopenia. After 15min of starting of IV infusion of rituximab, he started having severe retrosternal chest pain, diagnosed as acute ST elevation inferior wall MI. Patient was pre-loaded with dual anti platelets. Coronary angiogram showed 100% occlusion of proximal RCA. Thrombosuction of this culprit RCA revealed underlying 90% stenosis. After that, PCI with balloon angioplasty of RCA was done. The procedure was terminated in the view of successful balloon angioplasty with good TIMI flow...
September 2016: Indian Heart Journal
B Sunil Abhishek, Sai C Vijay, V Avanthi, B Kumar
INTRODUCTION: Cardiovascular disorders are the major cause of mortality and morbidity globally as well as in India. In India, where resources are limited and majority of patients pay out of their own pocket, thrombolysis is still done for majority of STEMI cases. CASE SCENARIO: A 48-year-old male patient, nonhypertensive and nondiabetic, came to the ER with history of retrosternal chest pain suggestive of angina at rest. An Electrocardiogram (ECG) revealed ST-segment elevation in the anterior leads...
September 2016: Indian Heart Journal
Maryam Zangene, Atefeh Ashoori Barmchi, Mansour Rezaei, Firoozeh Veisi
The aim of this study was to investigate the role of serum Interleukin-6 (IL-6) as a predictive value to make decision for surgical interventions when ovarian torsion (OT) is suspected. This study was performed on 284 women with lower abdominal pain. IL-6 levels were compared between OT (n = 67, 23.6%) and control groups (n = 217, 76.4%). For the purpose of diagnosis of OT, sensitivity and specificity of IL-6 at the cut-off point of 9.6 pg/ml were 41.79 and 82.49%, respectively. Patients with ovarian masses on ultrasound and IL-6 >9...
October 18, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
M Andriamamonjy, J-B Delmotte, F Savinelli, H Beaussier, F Coudore
INTRODUCTION: Oxaliplatin is a platinum derivate widely used in cancer treatment but producing dose-limiting peripheral neurotoxicity. Acute neuropathy is characterized by a transient cold-induced distal allodynia whereas chronic neuropathy leads to sensory loss. In order to design a method for quantitative assessment of oxaliplatin-induced peripheral neuropathy, we developed a study that aims to characterize the most appropriate skin area of the hand to perform sensory tests. METHODS: We included patients treated during at least 6 months with oxaliplatin...
October 1, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
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