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https://www.readbyqxmd.com/read/29351311/the-quality-of-voluntary-medical-male-circumcision-done-by-mid-level-workers-in-tshwane-district-south-africa-a-retrospective-analysis
#1
Sanele Ngcobo, Jacqueline Elizabeth Wolvaardt, Martin Bac, Elize Webb
BACKGROUND: Voluntary medical male circumcision (VMMC) reduces the acquisition of human immunodeficiency virus (HIV) in heterosexual men by up to 60%. One HIV infection is averted for every 5 to 15 VMMCs. To conduct VMMCs in large populations, large numbers of trained healthcare professionals are needed. Countries in Sub-Saharan Africa have a high burden of HIV and a shortage of healthcare professionals, creating a healthcare conundrum. To bridge this gap, South Africa launched a new cadre of mid-level medical worker called Clinical Associates (CA)...
2018: PloS One
https://www.readbyqxmd.com/read/29351141/an-exploration-of-emergency-physicians-attitudes-toward-patients-with-substance-use-disorder
#2
Cecelia Kathleen Mendiola, Giorgio Galetto, Michael Fingerhood
OBJECTIVES: Much is known about some healthcare professionals' attitudes toward patients with substance use disorders, but few studies have specifically looked at emergency department (ED) physicians. Individuals with substance use disorders are more likely to be people who chronically, frequently use the ED, and thus ED physicians are in a unique position to provide early identification and intervention for people struggling with addiction. The purpose of this study was to understand ED physicians' attitudes toward patients with substance use disorder with the aim of decreasing stigma and improving the care of ED patients with substance use disorder...
January 18, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29351125/central-inhibition-of-granulocyte-macrophage-colony-stimulating-factor-is-analgesic-in-experimental-neuropathic-pain
#3
Louise S C Nicol, Peter Thornton, Jon P Hatcher, Colin P Glover, Carl I Webster, Matthew Burrell, Kessia Hammett, Clare A Jones, Matthew A Sleeman, Andrew Billinton, Iain Chessell
With less than 50% of patients responding to the current standard of care and poor efficacy and selectivity of current treatments, neuropathic pain continues to be an area of considerable unmet medical need. Biological therapeutics such as monoclonal antibodies (mAbs) provide better intrinsic selectivity; however, delivery to the central nervous system (CNS) remains a challenge. Granulocyte-macrophage colony-stimulating factor (GM-CSF) is well described in inflammation-induced pain, and early-phase clinical trials evaluating its antagonism have exemplified its importance as a peripheral pain target...
January 16, 2018: Pain
https://www.readbyqxmd.com/read/29351123/accuracy-of-18f-naf-pet-ct-in-bone-metastasis-detection-and-its-effect-on-patient-management-in-patients-with-breast-carcinoma
#4
Wouter A M Broos, Friso M van der Zant, Maurits Wondergem, Remco J J Knol
OBJECTIVE: Determination of the accuracy of sodium fluorine-18-fluoride (F-NaF) PET/computed tomography (CT) for the evaluation of bone metastases, and the impact on patient management in breast cancer patients. PATIENTS AND METHODS: Patients with breast cancer, referred for F-NaF PET/CT between February 2014 and June 2016, were included in a database. Baseline characteristics, clinical indication, definitive diagnosis according to follow-up data, as well as changes in patient management were recorded...
January 18, 2018: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/29351095/the-effect-of-ketorolac-on-thoracolumbar-posterolateral-fusion-a-systematic-review-and-meta-analysis
#5
Jesse Li, Remi M Ajiboye, Michael H Orden, Akshay Sharma, Austin Drysch, Sina Pourtaheri
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: The purpose of this study was to evaluate the effect of postoperative ketorolac administration (ie, dosage and duration of use) on pseudarthrosis following thoracolumbar posterolateral spinal fusions. SUMMARY OF BACKGROUND DATA: Ketorolac is a nonsteroidal anti-inflammatory drug often administered for pain control after spine surgery. The main concern with ketorolac is the risk of pseudarthrosis following fusion...
January 18, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29351050/hidden-medical-devices-in-the-school-setting-what-the-school-nurse-needs-to-know-about-the-safe-use-of-baclofen-pumps
#6
Barbara Obst, Megan Roesler
One of the "hidden" medical devices in the school setting is the baclofen pump, which is used for the treatment of spasticity. The goals of spasticity treatment are to decrease muscle tone, deformity, and pain in order to maximize function and ease of care for both child and caregiver. The use of an intrathecal baclofen pump, often for children with cerebral palsy, spinal cord injury, brain injury, or stroke, has been effective in spasticity treatment. It is important for school nurses to be aware of the safety implications associated with this type of device...
January 1, 2018: NASN School Nurse
https://www.readbyqxmd.com/read/29350481/emotion-regulation-and-positive-affect-in-the-context-of-salivary-alpha-amylase-response-to-pain-in-children-with-cancer
#7
Brooke N Jenkins, Douglas A Granger, Ryan J Roemer, Ariana Martinez, Tara K Torres, Michelle A Fortier
BACKGROUND: Children with cancer routinely undergo painful medical procedures invoking strong physiological stress responses. Resilience to this pain may be conferred through resources such as emotion regulation strategies and positive affect. PROCEDURE: This study measured dispositional positive affect in children with cancer (N = 73) and randomly assigned participants to one of three emotion regulation strategy conditions (distraction, reappraisal, or reassurance)...
January 19, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29350325/evaluation-and-management-of-rotator-cuff-tears-a-primary-care-perspective
#8
REVIEW
Ross Mathiasen, Christopher Hogrefe
PURPOSE OF REVIEW: To provide a primary care perspective regarding the evaluation and management of shoulder pain and rotator cuff tears. RECENT FINDINGS: In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting. Partial-thickness rotator cuff tears remain difficult to diagnose with a single imaging modality. Musculoskeletal education in medical schools and non-orthopaedic residency and fellowship training programs continues to be an area for additional improvement...
January 19, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29349561/sphenopalatine-ganglion-stimulation-for-cluster-headache-results-from-a-large-open-label-european-registry
#9
Mads Barloese, Anja Petersen, Philipp Stude, Tim Jürgens, Rigmor Højland Jensen, Arne May
BACKGROUND: Cluster headache (CH) is a disabling primary headache disorder characterized by severe periorbital pain. A subset of patients does not respond to established pharmacological therapy. This study examines outcomes of a cohort of mainly chronic CH patients treated with sphenopalatine ganglion (SPG) stimulation. METHODS: Patients were followed in an open-label prospective study for 12 months. Ninety-seven CH patients (88 chronic, 9 episodic) underwent trans-oral insertion of a microstimulator targeting the SPG...
January 18, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/29349408/infolding-of-fenestrated-endovascular-stent-graft
#10
Jason G E Zelt, Prasad Jetty, Adnan Hadziomerovic, Sudhir Nagpal
We report a case of infolding of a fenestrated stent graft involving the visceral vessel segment after a juxtarenal abdominal aorta aneurysm repair. The patient remains free of any significant endoleak, and the aortic sac has shown regression. The patient remains asymptomatic, with no abdominal pain, with normal renal function, and without ischemic limb complications. We hypothesize that significant graft oversizing (20%-30%) with asymmetric engineering of the diameter-reducing ties may have contributed to the infolding...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29347935/real-world-experience-of-women-using-extended-cycle-vs-monthly-cycle-combined-oral-contraception-in-the-united-states-the-national-health-and-wellness-survey
#11
Rossella E Nappi, Iñaki Lete, Lulu K Lee, Natalia M Flores, Marie-Christine Micheletti, Boxiong Tang
BACKGROUND: The real-world experience of women receiving extended-cycle combined oral contraception (COC) versus monthly-cycle COC has not been reported. METHODS: Data were from the United States 2013 National Health and Wellness Survey. Eligible women (18-50 years old, premenopausal, without hysterectomy) currently using extended-cycle COC (3 months between periods) were compared with women using monthly-cycle COC. Treatment satisfaction (1 "extremely dissatisfied" to 7 "extremely satisfied"), adherence (8-item Morisky Medication Adherence Scale©), menstrual cycle-related symptoms, health-related quality of life (HRQOL) and health state utilities (Medical Outcomes Short Form Survey-36v2®), depression (9-item Patient Health Questionnaire), sleep difficulties, Work Productivity and Activity Impairment-General Health, and healthcare resource use were assessed using one-way analyses of variance, chi-square tests, and generalized linear models (adjusted for covariates)...
January 18, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29347932/epidemiology-of-arthritis-chronic-back-pain-gout-osteoporosis-spondyloarthropathies-and-rheumatoid-arthritis-among-1-5-million-patients-in-australian-general-practice-nps-medicinewise-medicineinsight-dataset
#12
David Alejandro González-Chica, Simon Vanlint, Elizabeth Hoon, Nigel Stocks
BACKGROUND: Previous estimates for the prevalence of musculoskeletal conditions (MSK) and chronic pain in Australia have been based on self-report. We aimed to determine the prevalence and distribution of arthritis, chronic back pain, gout, osteoporosis, spondyloarthropathies and rheumatoid arthritis and current consultations for chronic pain among adults attending Australian general practice, and describe their distribution according to sociodemographic characteristics and presence of co-morbidities...
January 18, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29346699/teaching-chronic-pain-in-the-family-medicine-residency
#13
Kimberly Zoberi, Kelly M Everard
BACKGROUND AND OBJECTIVES: Chronic pain is a significant condition affecting many Americans. Primary care physicians play an important role in chronic pain management, but many residents and physicians feel poorly prepared to manage it. METHODS: Data were collected as part of the 2016 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey, which was sent electronically to 484 program directors in the United States. The authors sought to determine whether residency directors' attitudes about treating chronic pain were associated with the amount of time devoted to teaching family medicine residents about chronic pain assessment, therapy (use of opioids, use adjuvant pain medications, use of other nonopioids, use of nonpharmacological treatments), and risk management (risk assessment, use of pain management contracts, informed consent when prescribing opioids, and urine drug monitoring)...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29346579/web-based-cognitive-behavior-therapy-for-chronic-pain-patients-with-aberrant-drug-related-behavior-outcomes-from-a-randomized-controlled-trial
#14
Honoria Guarino, Chunki Fong, Lisa A Marsch, Michelle C Acosta, Cassandra Syckes, Sarah K Moore, Ricardo A Cruciani, Russell K Portenoy, Dennis C Turk, Andrew Rosenblum
Objective: There is high unmet need for effective behavioral treatments for chronic pain patients at risk for or with demonstrated histories of opioid misuse. Despite growing evidence supporting technology-based delivery of self-management interventions for chronic pain, very few such programs target co-occurring chronic pain and aberrant drug-related behavior. This randomized controlled trial evaluated the effectiveness of a novel, web-based self-management intervention, grounded in cognitive behavior therapy, for chronic pain patients with aberrant drug-related behavior...
January 13, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29346264/sonography-of-the-cecum-gateway-to-the-right-lower-quadrant
#15
R Brooke Jeffrey, Andrew L Wentland, Eric W Olcott
Sonography of the cecum has come of age largely as a consequence of the successful evolution of appendiceal sonography as a useful tool in the evaluation of patients with right lower-quadrant pain. At some medical centers, graded-compression sonography (GCS) has become the initial imaging study of choice in the assessment of these individuals. The cecum serves as a helpful anatomic landmark for localization of the appendix in these examinations-providing a sonographic starting point in the search for the appendix...
January 17, 2018: Ultrasound Quarterly
https://www.readbyqxmd.com/read/29346235/posttraumatic-stress-in-children-after-injury-the-role-of-acute-pain-and-opioid-medication-use
#16
Aimee K Hildenbrand, Nancy Kassam-Adams, Lamia P Barakat, Kristen L Kohser, Jeffrey A Ciesla, Douglas L Delahanty, Joel A Fein, Lindsay B Ragsdale, Meghan L Marsac
OBJECTIVES: After injury, many children experience posttraumatic stress symptoms (PTSS) that negatively impact recovery. Acute pain and PTSS share neurobiological pathways, and acute dosage of morphine has been linked to reduced PTSS in naturalistic studies. However, the complex interactions between pain, morphine and other opioid use, and PTSS have yet to be investigated in robust pediatric samples.This prospective, longitudinal study examined relationships between acute pain, opioid medications, and PTSS after pediatric injury...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346231/the-complex-association-of-race-ethnicity-with-pain-treatment-quality-in-an-urban-medical-center-with-2-pediatric-emergency-departments
#17
Erika M Kipping, James M Chamberlain
OBJECTIVE: This study aimed to explore racial differences in analgesia quality. METHODS: A retrospective cross-sectional study of 24,733 visits by individuals 21 years or younger with pain scores of 4 to 10 was performed using electronic medical records. We compared 2 process metrics, treatment with any analgesics within 60 minutes and treatment with opioids within 60 minutes, and one outcome metric, a reduction in pain score by 2 or more points within 90 minutes...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346227/refractory-pain-management-in-amyloid-associated-peripheral-neuropathy
#18
Nafisseh S Warner, James C Watson, Markus A Bendel, Susan M Moeschler
OBJECTIVE: Systemic amyloidosis is a disease that often involves multiple organ systems, including the peripheral nervous system. Patients may present with severe, refractory neuropathic pain; however, the optimal treatment approach for pain for these patients remains unclear. CASE REPORT: A man with severe, refractory neuropathic pain in his bilateral upper and lower extremities and the trunk secondary to amyloid neuropathy is presented. Multiple medication trials, including neuropathic and opioid agents, produced considerable adverse effects and minimal relief...
January 17, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29345690/clozapine-induced-myocarditis
#19
COMMENT
Tanuka Datta, Allen J Solomon
Approved in 1989 for the management of treatment-resistant schizophrenia, Clozapine is a last-line atypical antipsychotic drug used with increasing frequency. In addition to its well-known side effect of agranulocytosis, this drug also carries with it rare but serious adverse cardiovascular risk of myocarditis. We present a patient on Clozapine who was admitted to the cardiology service with chest pain, ST segment elevations and elevated troponin concerning for acute myocardial infarction. Evaluation with imaging revealed decreased left ventricular function, however, no coronary artery disease was present on catheterization; findings consistent with a diagnosis of myocarditis...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29345595/hospital-management-of-severe-hypertriglyceridemia-in-children
#20
Ambika Ashraf, Badhma Valaiyapathi
Severe hypertriglyceridemia (HTG), i.e., triglyceride levels exceeding 1000 mg/dL, is one of the established causes of acute pancreatitis and severe abdominal pain. There are no established pediatric guidelines for treatment of children and adolescents with severe HTG. Management often includes hospital admission, fasting followed by fat free diet until the triglyceride (TG) levels are below 1000 mg/dL. Insulin infusion lowers TG levels in patients, especially in those with diabetes. Plasmapheresis is a limited option due to its restricted availability and scarcity of studies on its efficacy and safety in children...
January 16, 2018: Current Pediatric Reviews
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