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https://www.readbyqxmd.com/read/29655809/acute-limb-ischemia-in-an-8-year-old-patient-case-report
#1
Young Erben, Samuel M Miller, Brandon J Sumpio, Brian J Dillon, Alfred I Lee, Peter Blume, Bauer E Sumpio, Carlos Mena-Hurtado
We report the case of an 8-year-old patient with a history of nephrotic syndrome (NS), who presented to the emergency department (ED) with right foot pain. The patient's mother described intermittent pain that woke her son from sleep and was accompanied by the foot turning purple and becoming cold to touch. Physical exam revealed capillary refill of over ten seconds in the right and less than two seconds in the left foot. Ankle-brachial indices (ABI) were 0.0 on the right and 0.96 on the left. The patient was admitted and started on therapeutic intravenous heparin...
April 12, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29653184/estrogen-alleviates-neuropathic-pain-induced-after-spinal-cord-injury-by-inhibiting-microglia-and-astrocyte-activation
#2
Jee Youn Lee, Hae Young Choi, Bong Gun Ju, Tae Young Yune
Neuropathic pain after spinal cord injury (SCI) is developed in about 80% of SCI patients and there is no efficient therapeutic drug to alleviate SCI-induced neuropathic pain. Here we examined the effect of estrogen on SCI-induced neuropathic pain at below-level and its effect on neuroinflammation as underlying mechanisms. Neuropathic pain is developed at late phase after SCI and a single dose of 17β-estradiol (100, 300 μg/kg) were administered to rats with neuropathic pain after SCI through intravenous injection...
April 10, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29652784/a-prospective-randomized-multicenter-study-comparing-silicated-calcium-phosphate-versus-bmp-2-synthetic-bone-graft-in-posterolateral-instrumented-lumbar-fusion-for-degenerative-spinal-disorders
#3
Marc Coughlan, Mark Davies, Adriaan K Mostert, Dharmin Nanda, Paul C Willems, Geoffrey Rosenberg, Richard Ferch
STUDY DESIGN: A prospective, Phase IV, multicenter, randomized study. OBJECTIVE: To compare vertebral fusion success rates following posterolateral fusion ((PLF)/posterolateral intertransverse fusion (PITF)) surgery. The surgical procedure combined posterior lumbar interbody fusion (PLIF) and PLF with internal fixation over one or two levels using silicated calcium phosphate (SiCaP) or bone morphogenetic protein (BMP)-2 as graft material in patients with a degenerative disorder of the lumbar spine...
April 12, 2018: Spine
https://www.readbyqxmd.com/read/29652112/mucopexy-recto-anal-lifting-mu-ral-a-standardized-minimally-invasive-method-of-managing-symptomatic-hemorrhoids-with-an-innovative-suturing-technique-and-the-hemorpex-system%C3%A2
#4
Claudio Pagano, Contardo Vergani, Carlo Invernizzi, Massimo Bussone, Guido Benegiamo, Marco Venturi
BACKGROUND: Conservative surgery of hemorrhoidal disease is less painful than traditional hemorrhoidectomy, and mucopexy has less risk of serious postoperative complications than stapled hemorrhoidopexy. The aim of this study was to evaluate the safety and effectiveness of a standardized, modified hemorrhoidopexy, named Mucopexy-Recto Anal Lifting (MuRAL),with the HemorPex System (HPS) in patients with symptomatic III and IV degree hemorrhoids. MATERIALS AND METHODS: Patients were enrolled from May 2013 to Dec 2015 and operated on with the MuRAL technique, based on arterial ligation and mucopexy at 6 locations, using a standardized clockwise/anti-clockwise rotation sequence of the HPS anoscope...
April 12, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29650378/long-term-clinical-outcome-after-titanium-lunate-arthroplasty-for-kienb%C3%A3-ck-disease
#5
Timo Viljakka, Kaj Tallroth, Martti Vastamäki
PURPOSE: Titanium lunate arthroplasty (TLA) for Kienböck disease was introduced in 1984 to address the silicone-wear particle problem common to silicone lunate implants. We sought to study the outcome of TLA. METHODS: We identified 11 patients from our hospital database who had undergone TLA between 2001 and 2010. We evaluated pain, range of motion (ROM), function, and radiological outcome at a mean 11 years after surgery. We compared preoperative ROM and radiological findings with final follow-up in the ipsilateral wrist and also made comparisons with the contralateral wrists...
April 9, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29650343/safety-efficacy-and-management-of-subcutaneous-treprostinil-infusions-in-the-treatment-of-severe-pediatric-pulmonary-hypertension
#6
Marilyne Levy, Maria-Jesus Del Cerro, Sophie Nadaud, Karunakar Vadlamudi, Elizabeth Colgazier, Jeff Fineman, Damien Bonnet, Ian Adatia
BACKGROUND: Continuous intravenous epoprostenol was the first treatment approved for pulmonary arterial hypertension (PAH) but administration through a central venous line carries risks of thrombosis and sepsis, particularly in children. We sought to evaluate the safety, efficacy and management of subcutaneous (SC) treprostinil in children with PAH. METHODS: Fifty-six children (median age 65, range 1-200 months) were treated with SC treprostinil. Clinical status, echocardiography, NT-proBNP, and site pain and infection were evaluated...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29649666/a-retrospective-study-does-cigarette-smoking-induce-cervical-disc-degeneration
#7
Zhaoxiong Chen, Xinhua Li, Fumin Pan, Desheng Wu, Haoxi Li
OBJECTIVE: To investigate cigarette smoking's relevance with cervical disc degeneration. METHODS: We randomly selected 320 patients who came to our spine disease department outpatient clinic with chief complaint of neck-shoulder pain during June 2014-June 2016. According to the detailed smoking history, these patients were divided into 3 different groups, which were active smoker group (AS), passive smoking group (PS) and never-smoker group (NS). Each patient's Miyazaki's magnetic resonance imaging (MRI) classification of cervical disc degeneration was analyzed based on their cervical MRI films...
April 9, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29649012/clinical-improvements-are-not-explained-by-changes-in-tendon-structure-on-utc-following-an-exercise-program-for-patellar-tendinopathy
#8
Mathijs van Ark, Ebonie Rio, Jill Cook, Inge van den Akker-Scheek, James E Gaida, Johannes Zwerver, Sean Docking
OBJECTIVES: The aim of this study was to investigate the effects of a 4-week in-season exercise program of isometric or isotonic exercises on tendon structure and dimensions as quantified by Ultrasound Tissue Characterization (UTC). DESIGN: Randomized clinical trial. Volleyball and basketball players (16-31 years, n=29) with clinically diagnosed patellar tendinopathy were randomized to a 4-week isometric or isotonic exercise program. The programs were designed to decrease patellar tendon pain...
April 11, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29648876/use-of-patient-specific-3d-printed-titanium-implants-for-complex-foot-and-ankle-limb-salvage-deformity-correction-and-arthrodesis-procedures
#9
Travis J Dekker, John R Steele, Andrew E Federer, Kamran S Hamid, Samuel B Adams
BACKGROUND: The advancement of 3D printing technology has allowed for the use of custom-designed implants for difficult-to-treat foot and ankle pathologies. This study reports on the radiographic and functional outcomes of a case series of patients treated with patient-specific 3D-printed titanium implants. METHODS: Fifteen consecutive patients treated with custom-designed 3D-printed implant cages for severe bone loss, deformity correction, and/or arthrodesis procedures were included in this study...
April 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29645317/slow-infusion-of-low-hyphen-dose-ketamine-reduces-bothersome-side-effects-compared-to-iv-push-a-double-hyphen-blind-double-dummy-randomized-controlled-trial
#10
Eben J Clattenburg, Christian Hailozian, Daniel Haro, Tina Yoo, Stefan Flores, Derex Louie, Andrew A Herring
STUDY OBJECTIVE: We compared the analgesic efficacy and incidence of side effects when low{\hyphen}dose (0.3 mg{\sol}kg) ketamine (LDK) is administered as a slow infusion (SI) over 15 minutes versus an intravenous push (IVP) over one minute. METHODS: This was a prospective, randomized, double blind, double dummy, placebo{\hyphen}controlled trial of adult ED patients presenting with moderate to severe pain (numerical rating score ≥ 5). Patients received ketamine 0...
April 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29643876/clinical-effects-of-single-femoral-nerve-block-in-combination-with-general-anesthesia-on-geriatric-patients-receiving-total-knee-arthroplasty
#11
Jing Zhang, Yan Yuan, Yongjun Zhang, Ying Wang
Objective: To evaluate the clinical effects of single femoral nerve block (sFNB) combined with general anesthesia on geriatric patients receiving unilateral total knee arthroplasty (UTKA). Methods: Sixty geriatric UTKA patients who were treated in The First People's Hospital of Changzhou from January 2015 to August 2015 were randomly divided into an sFNB + laryngeal mask airway (FLA) group, an sFNB + tracheal intubation (FGA) group and a tracheal intubation (GA) group...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29643794/isolated-medial-orbital-wall-fracture-associated-with-enophthalmos-in-a-paediatric-patient-an-unusual-presentation
#12
Panagiotis Giannakouras, Georgios Pollalis, Efthymia Tsina
Purpose: To report a case of isolated medial orbital wall fracture with enophthalmos in a paediatric patient and describe the clinical presentation and findings by means of computed tomography (CT) of the head and eyes. Methods: We looked at the patient's medical and ophthalmologic history, and an ophthalmologic examination and a CT of the head were performed at baseline. Results: A 14-year-old boy was admitted to the emergency department of our institution with ecchymosis of his right eyelids secondary to a sport accident...
January 2018: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/29643163/effect-of-intratracheal-dexmedetomidine-administration-on-recovery-from-general-anaesthesia-after-gynaecological-laparoscopic-surgery-a-randomised-double-blinded-study
#13
Fei Wang, Haoxiang Zhong, Xiaoyan Xie, Weiping Sha, Caili Li, Zhenping Li, Zhuomei Huang, Chaojin Chen
OBJECTIVES: To examine the efficacy of intratracheal dexmedetomidine (Dex) injection for the prevention of the laryngeal response on emergence from general anaesthesia following gynaecological laparoscopic surgery. DESIGN: Prospective, randomised, double-blinded, controlled trial. SETTING: A general hospital, Guangdong Province, China. PARTICIPANTS: All patients who underwent elective laparoscopic gynaecological surgery, aged 18-60 years old, 40-80 kg in weight, American Society of Anesthesiologists class I-II were eligible...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29630134/clinical-efficacy-of-sequential-therapy-with-voriconazole-on-copd-patients-in-acute-phase-with-pulmonary-aspergillosis-and-effects-on-cytokines-and-pulmonary-functions
#14
J-F Du, Y-M Chi, Z Song, Q-G Di, J Shi, J Lv, Z-T Mai, M Li, B-H Sun, M-M Jiang
OBJECTIVE: To explore the clinical efficacy of sequential therapy with voriconazole on chronic obstructive pulmonary disease (COPD) patients in acute phase with pulmonary aspergillosis and its effects on cytokines and pulmonary functions. PATIENTS AND METHODS: A total of 110 COPD patients in acute phase with pulmonary aspergillosis who were admitted to the hospital between February 2015 and November 2016 were enrolled. We divided them randomly into two groups, i...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29630034/effective-dose-of-intravenous-dexmedetomidine-to-prolong-the-analgesic-duration-of-interscalene-brachial-plexus-block-a-single-center-prospective-double-blind-randomized-controlled-trial
#15
RyungA Kang, Ji Seon Jeong, Jae Chul Yoo, Ju Hyun Lee, Soo Joo Choi, Mi Sook Gwak, Tae Soo Hahm, Jin Huh, Justin Sangwook Ko
BACKGROUND AND OBJECTIVES: Intravenous (IV) dexmedetomidine (DEX) is reported to prolong the analgesic duration after single-shot interscalene brachial plexus block (ISBPB). However, the effective analgesic dose of IV DEX remains undetermined. Therefore, we aimed to elucidate the clinically relevant dose of IV DEX to prolong the analgesic duration of ISBPB. METHODS: Seventy-two patients scheduled for arthroscopic shoulder surgery received ISBPB with 15 mL of 0.5% ropivacaine with 1:200,000 epinephrine and were randomly assigned to 1 of 4 groups (n = 18, each): (1) IV normal saline (control), (2) IV DEX 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29630032/perineural-versus-systemic-dexamethasone-in-front-foot-surgery-under-ankle-block-a-randomized-double-blind-study
#16
Philippe Marty, Olivier Rontes, Clément Chassery, Corine Vuillaume, Bertrand Basset, Mehdi Merouani, Constance Marquis, Benoit Bataille, Martine Chaubard, Marie Claude Mailles, Fabrice Ferré, Alain Delbos
BACKGROUND AND OBJECTIVES: Among the different adjuvants, dexamethasone is one of the most accepted to prolong the effect of local anesthetics. This study aims to determine the superiority of perineural over systemic dexamethasone administration after a single-shot ankle block in metatarsal osteotomy. METHODS: We performed a prospective, double-blind, randomized study. A total of 100 patients presenting for metatarsal osteotomy with an ankle block were randomized into 2 groups: 30 mL ropivacaine 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29629601/occipital-neuralgia-associates-with-high-cervical-spinal-cord-lesions-in-idiopathic-inflammatory-demyelinating-disease
#17
Narayan R Kissoon, James C Watson, Christopher J Boes, Orhun H Kantarci
Background The association of trigeminal neuralgia with pontine lesions has been well documented in multiple sclerosis, and we tested the hypothesis that occipital neuralgia in multiple sclerosis is associated with high cervical spinal cord lesions. Methods We retrospectively reviewed the records of 29 patients diagnosed with both occipital neuralgia and demyelinating disease by a neurologist from January 2001 to December 2014. We collected data on demographics, clinical findings, presence of C2-3 demyelinating lesions, and treatment responses...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29628850/development-of-postoperative-central-anticholinergic-syndrome-due-to-low-dose-intravenous-fentanyl
#18
Hojae Cho, Jiyeon Kim
A 37-year-old female patient, 57 kg and 160 cm, underwent laparoscopic appendectomy. In the recovery room, fentanyl 100 mcg was intravenously administered for pain control. Three minutes after the administration, the patient developed intense and uncontrolled myoclonus, lower limb rigidity, agitation, aphasia, and periocular and neck swelling. The myoclonus and rigidity were suspected to be due to the opioid administration, and thus, naloxone was administered, but the symptoms were not improved. The patient's symptoms continued until the patient received administration of physostigmine...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628834/comparison-of-analgesic-efficacy-and-safety-of-continuous-epidural-infusion-versus-local-infiltration-and-systemic-opioids-in-video-assisted-thoracoscopic-surgery-decortication-in-pediatric-empyema-patients
#19
Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Introduction: The stripping of the densely innervated and inflamed parietal pleura in empyema during video-assisted thoracoscopic surgery (VATS) decortication can lead to significant pain and major postoperative respiratory compromise. Hence, we compared the analgesic efficacy of continuous epidural infusion versus local infiltration and systemic opioids in children undergoing VATS decortications. Methodology: Following ethics approval and informed consent, forty patients from 1 to 12 years of age were randomized into two groups, Group E (epidural) and Group L (local infiltration) after induction of anesthesia...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628676/metal-hypersensitivity-in-total-hip-and-knee-arthroplasty-current-concepts
#20
REVIEW
Samuel Akil, Jared M Newman, Neil V Shah, Natasha Ahmed, Ajit J Deshmukh, Aditya V Maheshwari
Metal hypersensitivity (MHS) is a rare complication of total joint arthroplasty that has been linked to prosthetic device failure when other potential causes have been ruled out. The purpose of this review was to conduct an analysis of existing literature in order to get a better understanding of the pathophysiology, presentation, diagnosis, and management of MHS. It has been described as a type IV hypersensitivity reaction to the metals comprising prosthetic implants, often nickel and cobalt-chromium. Patients suffering from this condition have reported periprosthetic joint pain and swelling as well as cutaneous, eczematous dermatitis...
January 2018: Journal of Clinical Orthopaedics and Trauma
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