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https://www.readbyqxmd.com/read/29909433/pharmacokinetics-of-fentanyl-sublingual-spray-in-opioid-na%C3%A3-ve-participants-results-of-a-phase-1-multiple-ascending-dose-study
#1
Richard L Rauck, D Alexander Oh, Neil Singla, Christian Koch, Neha Parikh, Srinivas Nalamachu, Jin Yu, Steven James
BACKGROUND AND OBJECTIVES: Fentanyl sublingual spray may be a viable alternative to intravenous (IV) opioids for the treatment of acute pain. As patients with acute pain may include those who have limited prior exposure to opioids, this phase 1, open-label, randomized, multiple ascending-dose study was conducted to assess the pharmacokinetics, pharmacodynamics, safety, and tolerability of multiple doses of fentanyl sublingual spray in opioid-naïve participants. This article primarily reports the pharmacokinetics results...
June 16, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29909297/results-of-surgical-treatment-of-de-quervain-s-tenosynovitis-80-cases-with-a-mean-follow-up-of-9-5-years
#2
Johanne J Garçon, Bertille Charruau, Emilie Marteau, Jacky Laulan, Guillaume Bacle
INTRODUCTION: Surgery is indicated in De Quervain's tenosynovitis only after failure of medical treatment, often due to individual anatomical variants. We use Le Viet's technique, to avoid tendon instability. The aim of the present study was to evaluate long-term results, with the hypothesis that this surgical technique is reliable, providing lasting results. PATIENTS AND METHODS: All patients operated on between 1993 and 2015 were included, and results were assessed by telephone questionnaire at a minimum 1 year's follow-up...
June 14, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29908355/medial-acetabular-wall-breach-in-total-hip-arthroplasty-is-full-weight-bearing-possible
#3
Filippo Mandelli, Simon Tiziani, Jürgen Schmitt, Clément M L Werner, Hans-Peter Simmen, Georg Osterhoff
BACKGROUND: A breach of the medial acetabular wall is a phenomenon seen frequently due to over-reaming during total hip arthroplasty (THA). The consequences of this issue are not fully understood particularly in cementless THA. A retrospective study was performed to answer whether: 1) immediate postoperative full-weight bearing in the presence of a medial acetabular wall breach after THA results in more short-term revisions of the acetabular component, 2) increases the risk for migration of the acetabular component? HYPOTHESIS: Immediate full-weight bearing in the presence of a medial breach is not associated with an increased likelihood for acetabular-related revision surgery or migration of the cup...
June 13, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29907602/improvised-first-aid-techniques-for-terrorist-attacks
#4
EDITORIAL
Andrew Loftus, Harvey Pynn, Paul Parker
Terrorist acts occur every day around the world. Healthcare professionals are often present as bystander survivors in these situations, with none of the equipment or infrastructure they rely on in their day-to-day practice. Within several countries there has been a move to disseminate the actions to take in the event of such attacks: in the UK, Run, Hide, Tell , and in the USA, Fight Back This paper outlines how a very basic medical knowledge combined with everyday high-street items can render highly effective first aid and save lives...
June 15, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29906380/points-pearls-managing-shoulder-injuries-in-the-emergency-department-fracture-dislocation-and-overuse
#5
Richard Pescatore, Andrew Nyce, Nachi Gupta, Jeffrey Nusbaum
The complex structures of the shoulder can be injured by fracture, dislocation, and overuse, and correctly identifying and classifying injury is essential to avoiding pain, disability, and life- and limb-threatening complications. This issue presents a systematic approach to classifying shoulder injuries based on the mechanism of injury and clinical presentation, choosing appropriate imaging, and determining the best strategies for treatment, including reduction, surgical consultation, or outpatient referral...
June 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29906252/pembrolizumab-for-patients-with-refractory-or-relapsed-thymic-epithelial-tumor-an-open-label-phase-ii-trial
#6
Jinhyun Cho, Hae Su Kim, Bo Mi Ku, Yoon-La Choi, Razvan Cristescu, Joungho Han, Jong-Mu Sun, Se-Hoon Lee, Jin Seok Ahn, Keunchil Park, Myung-Ju Ahn
Purpose Limited treatment options exist for patients with thymic epithelial tumor (TET) whose disease progresses after platinum-based chemotherapy. We conducted a phase II study of pembrolizumab in patients with TET to evaluate its efficacy and safety. Methods Patients with histologically confirmed TET whose disease progressed after at least one line of platinum-based chemotherapy were eligible for the study. Patients were excluded if they had an active autoimmune disease requiring systemic treatment within the past year or documented history of clinically severe autoimmune disease...
June 15, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29905767/the-multisystem-effects-of-simulated-agricultural-whole-body-vibration-on-acute-sensorimotor-physical-and-cognitive-performance
#7
Marcus Yung, Liana M Tennant, Stephan Milosavljevic, Catherine Trask
Background: Exposure to whole body vibration (WBV) is common in construction, agriculture, mining, and transportation. There is strong epidemiological evidence linking WBV with adverse health outcomes in the long-term, including low back pain. Fortunately, WBV exposure guidelines to prevent long-term musculoskeletal disorders and discomfort exist. In the shorter-term, it has been speculated that occupational levels of WBV may lead to increased risk of vehicle accidents and falls during egress; however, the acute effects of different vibration intensities remain poorly understood and it is uncertain whether established standards protect the worker from injurious short-term effects...
June 14, 2018: Annals of Work Exposures and Health
https://www.readbyqxmd.com/read/29905575/ce-original-research-the-efficacy-and-safety-of-an-rn-driven-ketamine-protocol-for-adjunctive-analgesia-during-burn-wound-care
#8
Laura Baumgartner, Nicole Townsend, Katie Winkelman, Robert MacLaren
Findings indicate that adjunctive low-dose ketamine was safe and provided pain relief. ABSTRACT: Objectives: Traditional analgesic regimens often fail to control the severe pain patients experience during burn wound care, and the drugs are frequently administered at doses that can cause oversedation and respiratory depression. Ketamine may be an ideal agent for adjunctive analgesia in such patients because of its unique mechanism of action and lack of association with respiratory depression...
June 13, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29904615/acute-pericarditis-as-a-presentation-of-adrenal-insufficiency
#9
Sukesh Manthri, Sindhura Bandaru, Abdisamad Ibrahim, Chaitanya K Mamillapalli
Acute pericarditis as a presenting sign of adrenal insufficiency is rarely reported. We present a rare case that highlights pericarditis as a clinical presentation of secondary adrenal insufficiency later complicated by cardiac tamponade. A 44-year-old lady who presented to the hospital with a one-day history of pleuritic chest pain and shortness of breath. In the emergency room, she had a blood pressure of 70/35 mmHg. Laboratory evaluation revealed white blood cell count of 16.08 k/cumm with neutrophilia, normal renal function and elevated troponin (0...
April 13, 2018: Curēus
https://www.readbyqxmd.com/read/29903851/improved-analgesia-by-correction-of-hypomagnesaemia
#10
Séamus Coyle, Daniel Monnery
The role of magnesium as an analgesic in patients is unclear. Hypomagnesaemia is a common electrolyte abnormality, in the chronic state symptoms are insidious and often non-specific. It is often undiagnosed and thus untreated. There is evidence from animal studies that magnesium is involved in pain control including an animal model of hyperalgesia induced by hypomagnesaemia. We report two cases of patients admitted for pain control which improved when hypomagnesaemia was treated. Each case had metastatic cancer...
June 14, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29902699/abuse-of-fentanyl-an-emerging-problem-to-face
#11
REVIEW
Katarzyna Kuczyńska, Piotr Grzonkowski, Łukasz Kacprzak, Jolanta B Zawilska
Fentanyl is a potent synthetic opioid used as a narcotic analgesic supplement in general and regional anesthesia as well as in management of persistent, severe chronic pain. Alarming epidemiological and forensic medicine reports, accumulated mainly during the last two decades, point to a growing increase in illicit use of fentanyl, mainly in North America and Europe. Toxicological data indicates that fentanyl use is inextricably linked with polydrug use. There are two main sources of fentanyl on the "recreational" drug market...
June 2, 2018: Forensic Science International
https://www.readbyqxmd.com/read/29901652/the-effects-of-preoperative-single-dose-thoracic-paravertebral-block-on-acute-and-chronic-pain-after-thoracotomy-a-randomized-controlled-double-blind-trial
#12
Xiu-Liang Li, Ye Zhang, Tian Dai, Lei Wan, Guan-Nan Ding
BACKGROUND: Patients undergoing thoracotomy frequently experience acute pain and chronic post-thoracotomy pain (CPTP). There are few articles relating to the investigations on the effects of preoperative single-dose thoracic paravertebral block (PSTPVB) on acute pain and CPTP. We tested the hypothesis that adding PSTPVB to intravenous (IV) patient-controlled analgesia (PCA) would reduce acute pain scores and decrease the incidence and intensity of CPTP. METHODS: Fifty-six patients undergoing elective thoracotomy were randomized to receive PSTPVB in addition to IV PCA (group T) or IV PCA alone (group C)...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29901630/three-primary-synchronous-malignancies-of-the-uterus-cervix-and-fallopian-tube-a-case-report
#13
Liang Song, Qingli Li, Kaixuan Yang, Rutie Yin, Danqing Wang
RATIONALE: Multiple primary malignancies can occur in the same organ or in multiple organs or systems. Likewise, they can occur simultaneously or successively. Based on the timing of the diagnosis, they are classified as multiple synchronous (i.e., concurrent) or metachronous (i.e., successive) primary malignancies. The vast majority of patients have multiple metachronous malignant tumors; multiple synchronous tumors are rare. PATIENT CONCERNS: A 63-year-old woman presented with the chief complaint of vaginal fluid discharge for 3 months and abdominal pain for 1 month...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29900214/data-regarding-clinical-evaluation-of-collagen-membrane-in-oral-mucosal-defects-due-to-oral-submucous-fibrosis-and-leukoplakia
#14
Veeraiah Chowdary Jasthi, Thorakkal Shamim
This data depicts the clinical evaluation of collagen membrane in oral mucosal defects due to oral submucous fibrosis and leukoplakia. This data comprised of 10 patients in the age group of 20-60 (3 male and 2 female patients with grade III and grade IV oral submucous fibrosis and 5 male patients with oral leukoplakia with a size of 3-5 cm in diameter). The parameters such as pain, swelling, allergy, biodegradability of collagen membrane, degree of re-epithelisation, degree of contracture, mouth opening and wound size were assessed after the placement of collagen membrane in oral mucosal defects...
June 2018: Data in Brief
https://www.readbyqxmd.com/read/29900082/tuberculous-arthritis-of-the-elbow-joint-an-uncommon-location-with-a-diagnostic-dilemma
#15
Neelam Khetpal, Sameen Khalid, Ranjeet Kumar, Manuel F Betancourt, Akash Khetpal, Christopher Wasyliw, Seema Patel
Musculoskeletal tuberculosis accounts for 1%-3% of all cases of tuberculosis (TB) worldwide with elbow involvement being even less common. The most cases of tuberculous arthritis occur in patients born in and emigrated from endemic regions, especially in patients who are co-infected with human immunodeficiency virus (HIV). We present a rare case of tuberculous septic arthritis of the elbow joint in a 78-year-old African-American female from the United States, with no history of travel abroad. Her presenting symptoms included pain, swelling, and decreased range of motion of the right elbow for six months...
April 11, 2018: Curēus
https://www.readbyqxmd.com/read/29900000/staphylococcus-associated-glomerulonephritis-mimicking-henoch-sch%C3%A3-nlein-purpura-and-cryoglobulinemic-vasculitis-in-a-patient-with-an-epidural-abscess-a-case-report-and-brief-review-of-the-literature
#16
Tahrin Mahmood, Robert Puckrin, Linda Sugar, David Naimark
Rationale: Staphylococcus-associated glomerulonephritis (SAGN) is a rare immune complex-mediated glomerulonephritis associated with active Staphylococcus infection. We report a case illustrating the importance of clinical history and kidney biopsy findings in establishing the correct diagnosis. Presenting concerns of the patient: We report the case of a 64-year-old man with alcohol-associated cirrhosis, type 2 diabetes mellitus, and hypertension who presented to hospital with lower back and abdominal pain, rectal bleeding, a purpuric lower extremity rash, and oliguric acute kidney injury with microscopic hematuria and nephrotic-range proteinuria...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29898707/comparison-of-intravenous-and-topical-tranexamic-acid-in-total-knee-arthroplasty
#17
Wenbo Wei, Shajie Dang, Dapeng Duan, Ling Wei
BACKGROUND: To investigate the clinical effectiveness of intravenous (IV) and topical tranexamic acid (TXA) in patients undergoing total knee arthroplasty (TKA) by comparing safety, efficacy and patient-reported outcomes. METHODS: In this prospective single-blind clinical trial, 64 patients were randomized into two groups (n = 32 each). The Intravenous Group was administered TXA 10 mg/kg IV (Reyong, Shandong, China) 10 min prior to tourniquet deflation. In the Topical Group, 1...
June 13, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29896558/are-reinfusion-drains-safe-to-use-with-periarticular-liposomal-bupivacaine-an-analysis-of-systemic-bupivacaine-toxicity
#18
Marc R Angerame, Gavin P Hart, Susan M Odum, Bryan D Springer
Background: Intraoperative periarticular injection (PAI) with local anesthetic is an important component of multimodal pain control in total joint arthroplasty (TJA). A potential risk of this practice is serum anesthetic toxicity resulting from the autotransfusion of blood collected from a reinfusion drain. The purpose of this study is to evaluate the levels of bupivacaine in blood collected in an autotransfusion system after use of a PAI in TJA. Methods: In this prospective study, each TJA patient had an identical PAI consisting of 20 cc of liposomal bupivacaine, 30 cc of 0...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29896022/incidence-management-and-outcome-assessment-of-post-operative-infection-following-single-bundle-and-double-bundle-acl-reconstruction
#19
Pallav Mishra, Ajay Lal, Mukul Mohindra, Nitin Mehta, Deepak Joshi, Deepak Chaudhary
Introduction: Post-operative infection is a dreadful complication of ACL reconstruction with gray zone over management guidelines. We aimed to establish commonest etiology, assess incidence of infection and effect on outcome, individually for single and double bundle ACL reconstruction techniques, so as to formulate appropriate management guidelines. Methods: Our prospective study involved 1152 patients operated for ACL reconstruction (437- DBACL, 715- SBACL) from 2010-2013...
April 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29895543/septic-arthritis-of-the-temporomandibular-joint-leading-to-an-epidural-abscess
#20
Joern Wittig, Farzad Borumandi, Alexander Gaggl, Johannes Hachleitner
Septic arthritis of the temporomandibular joint (TMJ) is rare, but patients with this diagnosis are at high risk for significant morbidity. We present a case of a 15-year-old man who presented with increasing trismus for 3 days. He had only minimal discomfort and swelling of the right cheek and temporal region, and pericoronitis of an impacted wisdom tooth was suspected. Under intravenous antibiotics, pain subsided, but trismus and a slight swelling remained. CT scan showed septic arthritis of the TMJ with an abscess formation penetrating into the epidural space...
June 11, 2018: BMJ Case Reports
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