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https://www.readbyqxmd.com/read/29679728/magnetic-resonance-imaging-of-the-lumbar-spine-determining-clinical-impact-and-potential-harm-from-overuse
#1
Nathan M Wnuk, Tarik K Alkasab, Daniel I Rosenthal
BACKGROUND: Lumbar spine MRI is frequently said to be "overused" in the evaluation of low-back pain, yet data concerning the extent of overuse and on potential harmful effects are lacking. PURPOSE: To determine the proportion of examinations with a detectable impact on patient care (actionable outcomes). STUDY DESIGN: Retrospective cohort study PATIENT SAMPLE: 5,365 outpatient lumbar spine MR examinations OUTCOME MEASURES: Actionable outcomes included: 1) findings leading to an intervention making use of anatomical information such as surgery; 2) new diagnoses of cancer, infection, or fracture; or 3) following known lumbar spine pathology...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29679691/newly-developed-endoscopic-detachable-snare-ligation-therapy-for-colonic-diverticular-hemorrhage-a-multicenter-phase-ii-trial-with-videos
#2
Daisuke Akutsu, Toshiaki Narasaka, Katsumasa Kobayashi, Kenji Matsuda, Mariko Wakayama, Yoshinori Hiroshima, Shinji Endo, Takashi Mamiya, Takahisa Watahiki, Kazuto Ikezawa, Hiroyasu Ishida, Mitsuaki Hirose, Yuji Mizokami, Ichinosuke Hyodo
BACKGROUND AND AIMS: We previously reported preliminary safety results for a new method, endoscopic detachable snare ligation (EDSL), for diverticular hemorrhage. This method does not need endoscope removal to attach a ligation device after detection of the bleeding site. The aim of the present study was to evaluate the efficacy and safety of EDSL in a larger patient population. METHODS: This prospective study was conducted in 12 institutions. Patients suspected of having diverticular hemorrhage without serious systemic disease were enrolled...
April 18, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29679681/inhibition-of-protein-kinase-a-and-girk-channel-reverses-fentanyl-induced-respiratory-depression
#3
Xiaonan Liang, Zheng Yong, Ruibin Su
Opioid-induced respiratory depression is a major obstacle to improving the clinical management of moderate to severe chronic pain. Opioids inhibit neuronal activity via various pathways, including calcium channels, adenylyl cyclase, and potassium channels. Currently, the underlying molecular pathway of opioid-induced respiratory depression is only partially understood. This study aimed to investigate the mechanisms of opioid-induced respiratory depression in vivo by examining the effects of different pharmacological agents on fentanyl-induced respiratory depression...
April 18, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29679240/a-case-of-tension-faecopneumothorax-after-delayed-diagnosis-of-traumatic-diaphragmatic-hernia
#4
Tien Yew Chern, Allan Kwok, Soni Putnis
BACKGROUND: Traumatic diaphragmatic injuries from blunt or penetrating trauma are difficult to detect in the acute setting and, if missed, can result in significant morbidity and mortality in the future. We present a case demonstrating the natural progression of this resulting in faecopneumothorax, which is a rare but serious presentation. CASE PRESENTATION: A 22-year-old young man presented with left upper quadrant and chest pain, nausea, vomiting, and intermittent obstipation with a background of previous lower chest wall stabbings...
April 20, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29679169/the-utility-of-scrotal-ultrasonography-in-the-emergent-setting-beyond-epididymitis-versus-torsion
#5
Christopher R McAdams, Andrew J Del Gaizo
Scrotal pain is a common acute presentation for medical care. Testicular torsion and epididymo-orchitis are two diagnoses for which early detection is critical and their sonographic imaging features have been thoroughly described in the radiologic literature. Other important conditions for which radiologists must be aware have received less attention. This article will highlight key traumatic and non-traumatic causes of acute scrotal pain other than testicular torsion and epididymo-orchitis that may present in the emergency department setting...
April 21, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29678839/diagnostic-and-differential-diagnostic-significance-of-laboratory-markers-in-crayfish-associated-rhabdomyolysis
#6
Caidong Liu, Haoyu Wang, Chenbin Zhu, Yishan Wang, Yanping Mei, Tianyi Gao, Yingdong Gao, Yongxiang Xia, William C Cho, Shukui Wang
CONTEXT: Haff disease is a rare syndrome of myalgia and rhabdomyolysis occurring within 24h of consumption of certain types of cooked freshwater fish or crustacean. OBJECTIVE: The white blood cell count (WBC), plasma creatine kinase (CK), creatine kinase isoenzyme (CK-MB), CK-MB/CK, troponin T (cTnT) and creatinine (Cr) were analyzed as diagnostic markers for crayfish ( Procambarus clarkii )-associated rhabdomyolysis (Haff disease). The significance of these laboratory markers in differentiating myocardial injury disease and Haff disease was explored...
March 2018: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/29678706/mid-term-clinical-and-radiological-outcomes-after-kyphoplasty-in-the-treatment-of-thoracolumbar-traumatic-vertebral-compression-fractures
#7
Michael Grelat, Rachid Madkouri, Pierre-Olivier Comby, Elie Fahed, Brivael Lemogne, Pierre Thouant
OBJECTIVE: The management of thoracolumbar post-traumatic compression fractures widely varies among centers, and there is no real consensus. The objective of our retrospective study was to detect the progression of vertebral kyphosis in non-osteoporotic patients treated by balloon kyphoplasty (KPB) who presented recent compression fractures of the thoracolumbar region. MATERIALS AND METHODS: From 2007 to 2011, we focused in this retrospective study on the vertebral and regional kyphosis evolution in 77 patients treated by KPB for compression vertebral fractures (Magerl A)...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29678668/the-effect-of-music-on-postoperative-recovery-in-older-patients-a-systematic-review
#8
Hanneke van der Wal-Huisman, Karolien S K Dons, Rineke Smilde, Erik Heineman, Barbara L van Leeuwen
OBJECTIVE: Surgery is an important part of the treatment modalities offered to older patients with cancer. Natural ageing processes lead to deterioration of organ function, making older patients more vulnerable and at risk for experiencing less-favourable outcomes and complications after surgery. Non-pharmaceutical interventions, such as music, may be preferable to medical interventions in older people, who are at risk for adverse effects and drug interactions due to altered physiology and drug metabolism...
April 17, 2018: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29676837/twelve-year-follow-up-of-chronic-pain-in-twins-changes-in-environmental-and-genetic-influence-over-time
#9
A Burri, S Ogata, D Rice, F M K Williams
BACKGROUND: While genetic influences on chronic pain have been repeatedly demonstrated, we do not know whether these effects are stable or dynamic over time. AIMS: To determine the temporal pattern of genetic and environmental effects to individual differences in chronic pain over 12 years, using a sample of N = 961 female twins. METHODS: Data on chronic pain was collected in 2004 (T1) and 2016 (T2) using the same comprehensive body map which divides the body into 31 distinct anatomical areas...
April 20, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29676689/intravenous-acetaminophen-for-postoperative-supratentorial-craniotomy-pain-a-prospective-randomized-double-blinded-placebo-controlled-trial
#10
Walavan Sivakumar, Michael Jensen, Julie Martinez, Michael Tanana, Nancy Duncan, Robert Hoesch, Jay K Riva-Cambrin, Craig Kilburg, Safdar Ansari, Paul A House
OBJECTIVE Acute pain control after cranial surgery is challenging. Prior research has shown that patients experience inadequate pain control post-craniotomy. The use of oral medications is sometimes delayed because of postoperative nausea, and the use of narcotics can impair the evaluation of brain function and thus are used judiciously. Few nonnarcotic intravenous (IV) analgesics exist. The authors present the results of the first prospective study evaluating the use of IV acetaminophen in patients after elective craniotomy...
April 20, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29675983/the-natural-history-of-asymptomatic-calyceal-stones
#11
Maitrey Padmasambhav Darrad, Sachin Yallappa, John Metcalfe, Kesavapillai Subramonian
OBJECTIVES: To evaluate the outcomes of patients with incidentally detected asymptomatic calyceal stones on active surveillance, and to identify risk factors for stone-related adverse events. SUBJECTS & METHODS: In this retrospective case series, we identified all renal units with non-contrast CT diagnosed asymptomatic calyceal stones in a single reference centre between August 2005 and August 2016. Primary endpoints were spontaneous stone passage and need for stone-related surgical intervention...
April 19, 2018: BJU International
https://www.readbyqxmd.com/read/29675722/contrast-enhanced-or-noncontrast-ct-for-renal-colic-utilizing-urinalysis-and-patient-history-of-urolithiasis-to-decide
#12
Vishal Desai, Mougnyan Cox, Sandeep Deshmukh, Christopher G Roth
PURPOSE: In the emergency setting, flank pain commonly leads to a noncontrast CT despite a significant percentage of patients having alternative diagnoses, often difficult to characterize without contrast. We investigated the combined utility of urinalysis and history of urolithiasis in identifying patients who are unlikely to have urolithiasis and may benefit from a contrast-enhanced study. METHODS: Retrospective review of 350 patients from May 2013 to May 2016 was performed for patients in the emergency department with renal colic that underwent noncontrast CT and urinalysis testing...
April 20, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29675599/immunoadsorption-plasmapheresis-treatment-for-the-recurrent-exacerbation-of-neuromyelitis-optica-spectrum-disorder-with-a-fluctuating-anti-aquaporin-4-antibody-level
#13
Hiroaki Nishimura, Hideki Enokida, Taiji Sakamoto, Toshiyuki Takahashi, Hiroshi Hayami, Masayuki Nakagawa
The pathogenesis in the exacerbation of neuromyelitis optica spectrum disorder (NMOSD) involves mainly the serum anti-aquaporin-4 (AQP4) immunoglobulin G antibody (anti-AQP4 antibody). If high-dose corticosteroid treatment is not achieved during remission, rescue plasmapheresis is recommended. However, there are few reports on the therapeutic efficacy of repetitive immunoadsorption plasmapheresis (IAPP) for the recurrent exacerbation of NMOSD with a fluctuating anti-AQP4 antibody level. A 36-year-old man presented with a reduction of visual acuity (VA) on the right eye (OD) to 20/250...
April 19, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29674769/helicobacter-cinaedi-associated-carotid-arteritis
#14
Shinichiro Nakao, Hideharu Hagiya, Keigo Kimura, Tomomi Mitsui, Akane Oyama, Kazuhiro Hongyo, Yusuke Takahashi, Futoshi Nakagami, Kazunori Tomono, Hiromi Rakugi
A 65-year-old Japanese man with bilateral carotid atherosclerosis presented with right neck pain and fever. Contrast-enhanced computed tomography suggested carotid arteritis, and carotid ultrasonography showed an unstable plaque. The patient developed a cerebral embolism, causing a transient ischemic attack. Helicobacter cinaedi was detected in blood culture, and H. cinaedi-associated carotid arteritis was diagnosed. Empirical antibiotic therapy was administered for 6 weeks. After readmission for recurrent fever, he was treated another 8 weeks...
April 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29673262/psychometric-properties-of-the-numeric-pain-rating-scale-and-neck-disability-index-in-patients-with-cervicogenic-headache
#15
Ian A Young, James Dunning, Raymond Butts, Joshua A Cleland, César Fernández-de-Las-Peñas
Background Self-reported disability and pain intensity are commonly used outcomes in patients with cervicogenic headaches. However, there is a paucity of psychometric evidence to support the use of these self-report outcomes for individuals treated with cervicogenic headaches. Therefore, it is unknown if these measures are reliable, responsive, or result in meaningful clinically important changes in this patient population. Methods A secondary analysis of a randomized clinical trial (n = 110) examining the effects of spinal manipulative therapy with and without exercise in patients with cervicogenic headaches...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29672812/cartilage-imaging-techniques-and-developments
#16
Edwin H G Oei, Marius C Wick, Anja Müller-Lutz, Christoph Schleich, Falk R Miese
Cartilage degeneration is one of the most common chronic age-related joint disorders leading to pain and reduced joint motion. The increasing prevalence of osteoarthritis requires accurate cartilage imaging, both clinically and in research. Detailed cartilage imaging is also necessary for traumatic cartilage lesions and for pre- and postoperative assessment of cartilage repair procedures. Although still widely used, conventional radiography bears significant limitations because it assesses cartilage indirectly by joint space width...
April 2018: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/29672771/effects-of-subclinical-footpad-dermatitis-and-emotional-arousal-on-surface-foot-temperature-recorded-with-infrared-thermography-in-turkey-toms-meleagris-gallopavo
#17
R O Moe, J Bohlin, A Flø, G Vasdal, H Erlandsen, E Guneriussen, E C Sjökvist, S M Stubsjøen
Footpad dermatitis is a condition that causes lesions on the plantar surface of the footpads in growing turkeys. Potential inflammatory processes and pain associated with increasing severity of footpad dermatitis raise animal welfare concerns. This study investigated whether the temperature of the plantar surface of the foot (the footpads and the entire plantar foot including interdigital membranes) assessed with infrared thermography reflects severity of mild footpad dermatitis as assessed with a Visual Analogue Scale in 80 turkey toms at 10 weeks of age...
April 17, 2018: Poultry Science
https://www.readbyqxmd.com/read/29672249/urinary-tract-infection-by-strongyloides-stercoralis-a-case-report
#18
Nilo Manoel Pereira Vieira Barreto, Joelma Nascimento de Souza, Weslei Almeida Costa Araujo, Nadia Andrade Khouri, Ernesto Pereira de Oliveira, Márcia Cristina Aquino Teixeira, Neci Matos Soares
The objective of this study was to report a case of a hydronephrotic patient with Strongyloides stercoralis infection, with discharge of rhabditoid larva exclusively in urine. In 2013, a 72-yr-old, male patient, hypertensive, obese and diagnosed with hydronephrosis secondary to renal calculi, reported lumbar pain, polyuria, polaciuria and dysuria, as well as frequent urinary tract infections. The microscopic analysis of urine sediment showed the presence of S. stercoralis rabditoid larva. However, parasitological examinations by Baermann-Moraes, agar plate culture and spontaneous sedimentation, performed with 3 fecal samples on alternate days had negative results...
April 19, 2018: Journal of Parasitology
https://www.readbyqxmd.com/read/29672210/prognostic-utility-of-stress-testing-and-cardiac-biomarkers-in-menopausal-women-at-low-to-intermediate-risk-for-coronary-artery-disease-smart-study-5-year-outcome
#19
Sahar S Abdelmoneim, Caroline A Ball, Francesca Mantovani, Mary E Hagen, Susan Eifert-Rain, Susan Wilansky, Ramon Castello, Patricia A Pellikka, Patricia J M Best, Sharon L Mulvagh
BACKGROUND: In women with low to intermediate risk of coronary artery disease (CAD), prognostic detection strategies have been controversial. We present the follow-up data of the SMART trial in peri/postmenopausal women at low to intermediate risk of CAD. OBJECTIVES: To determine the value of contrast stress echocardiography (CSE), stress electrocardiogram (sECG), and serum biomarkers for prediction of cardiovascular events (CE) in peri/postmenopausal women at low to intermediate risk of CAD...
April 19, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29669562/comfort-in-palliative-sedation-compas-a-transdisciplinary-mixed-method-study-protocol-for-linking-objective-assessments-to-subjective-experiences
#20
Stefaan Six, Steven Laureys, Jan Poelaert, Johan Bilsen, Peter Theuns, Reginald Deschepper
BACKGROUND: In case of untreatable suffering at the end of life, palliative sedation may be chosen to assure comfort by reducing the patient's level of consciousness. An important question here is whether such sedated patients are completely free of pain. Because these patients cannot communicate anymore, caregivers have to rely on observation to assess the patient's comfort. Recently however, more sophisticated techniques from the neurosciences have shown that sometimes consciousness and pain are undetectable with these traditional behavioral methods...
April 18, 2018: BMC Palliative Care
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