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https://www.readbyqxmd.com/read/27910253/a-computed-tomography-guided-demonstration-of-the-unilateral-distribution-of-low-volume-epidural-injectate
#1
Semih Gungor, Rohit Aiyer
The epidural space is frequently used for placement of the epidural needle, catheter, and various pharmacological agents. The presence of structures in the epidural space such as epidural fat, venous plexus, or ligaments that may lead to uneven distribution of agents within the epidural space have been described.(1-3) Whether these structures are anatomical (such as connective tissue) or functional (due to distortions of actual anatomy secondary to injection of agents epidurally) has been disputed.(2-5) We describe our management of a patient who presented with bilateral radicular symptoms and severe low back pain...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27908810/emergent-treatment-of-a-ruptured-thoraco-abdominal-aortic-aneurysm-by-off-label-rescue-implantation-of-the-ovation-%C3%A2-stent-graft-in-nonagenarians-patient
#2
Chiara Pranteda, Pasqualino Sirignano, Federica Fornelli, Wassim Mansour, Nunzio Montelione, Laura Capoccia, Francesco Speziale
We report a case of a compassionate treatment of a ruptured thoraco-abdominal aortic aneurysm in a 92-year-old patient. Patient was admitted to our emergency department for acute onset of pain irradiating to the back. Computed tomographic angiography showed the presence of a thoraco-abdominal aortic aneurysm with a contained rupture at infrarenal level. Given of the presence of a relative healthy visceral aorta, we decided to treat the patient by Ovation(®) (Endologix, Irvine, CA - USA) implantation in an off-label fashion...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27906739/posterior-vertebral-column-resection-with-intraoperative-manual-retraction-for-the-treatment-of-posttubercular-kyphosis-in-upper-thoracic-spine-or-cervicothoracic-junction
#3
Yuqiao Chen, Guohua Lü, Bing Wang, Lei Li, Lei Kuang
STUDY DESIGN: This is a case-series. OBJECTIVE: To evaluate the clinical and radiologic outcomes of posterior vertebral column resection (PVCR) for treatment of posttubercular kyphosis in upper thoracic spine and cervicothoracic junction (CTJ). SUMMARY OF BACKGROUND DATA: Surgical management of severe posttubercular kyphosis in upper thoracic spine or CTJ is challenging. A new technique that combines PVCR and intraoperative manual traction in a single procedure, was developed to maximize the correction rate and minimize the risk of dural buckling and spinal cord injury...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27904817/transitional-vertebra-and-spina-bifida-occulta-related-with-chronic-low-back-pain-in-a-young-patient
#4
Maryam Kundi, Maham Habib, Sumbal Babar, Asif K Kundi, Salman Assad, Amjad Sheikh
Bertolotti's syndrome (BS) must be considered as a differential diagnosis in a young patient presenting with low back pain (LBP). We present a case of a 26-year-old male complaining of mild chronic LBP for six years, radiating to his left thigh for the past six months. He has been taking non-steroidal anti-inflammatory drugs (NSAIDs) with skeletal muscle relaxants for pain relief. The X-ray and computed tomography (CT) imagings showed congenital enlargement of the left transverse process of the fifth lumbar (L5) vertebra forming pseudo-articulation with the sacrum and unilateral pars interarticularis defect at the L4 level on the left side, respectively...
October 19, 2016: Curēus
https://www.readbyqxmd.com/read/27900729/radical-resection-of-t1-pancreatic-adenocarcinoma-with-a-pseudocyst-of-the-tail-due-to-acute-obstructive-pancreatitis-report-of-a-case
#5
Yuki Fujiwara, Fumitake Suzuki, Masaru Kanehira, Yasuro Futagawa, Tomoyoshi Okamoto, Katsuhiko Yanaga
A 53-year-old male visited his primary physician for epigastric and back pain. Abdominal-enhanced computed tomography (CT) revealed a simple cyst of the pancreatic tail attached to the stomach. A distal main pancreatic duct (MPD) was clearly dilated, but no pancreatic tumor was identified around the stenosis of MPD by CT scan and magnetic resonance cholangiopancreatography (MRCP). Endoscopic retrograde pancreatography (ERP) revealed stenosis and distal dilation of the MPD located between the body and tail of the pancreas...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27900088/favorable-control-of-advanced-colon-adenocarcinoma-with-severe-bone-marrow-metastasis-a-case-report
#6
Fumiyasu Hanamura, Yoshihiro Shibata, Tsuyoshi Shirakawa, Miyuki Kuwayama, Hisanobu Oda, Hiroshi Ariyama, Kenichi Taguchi, Taito Esaki, Eishi Baba
Colorectal cancer (CRC) has a propensity to metastasize to the liver, lungs and regional abdominal lymph nodes, but rarely to the bone marrow. A 60-year-old man presented to the National Hospital Organization Kyushu Cancer Center with a 4-week history of persistent lower back pain, anorexia and difficulty defecating. Complete blood count revealed severe thrombocytopenia and erythroblastosis, suggesting a hematological malignancy. However, the bone marrow examination demonstrated involvement by a moderately to poorly differentiated adenocarcinoma, but no hematopoietic abnormalities...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27893671/scoliosis-secondary-to-lumbar-osteoid-osteoma-a-case-report-of-delayed-diagnosis-and-literature-review
#7
Haiping Zhang, Xingbang Niu, Biao Wang, Simin He, Dingjun Hao
RATIONALE: Lumbar osteoid osteoma has a low incidence, which could easily lead to scoliosis. PATIENT CONCERNS: Scoliosis secondary to lumbar osteoid osteoma could be easily misdiagnosed when patients do not complain of obvious symptoms. DIAGNOSES: We reported a case of a 9-year-old boy with back deformity that was firstly diagnosed with scoliosis at the local hospital. After prescribed with orthosis, the patient experienced aggravating pain that could not be relieved with painkillers...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27893667/abdominal-compartment-syndrome-after-endovascular-repair-for-ruptured-abdominal-aortic-aneurysm-leads-to-acute-intestinal-necrosis-case-report
#8
Xiyang Chen, Jichun Zhao, Bin Huang, Ding Yuan, Yi Yang, Yukui Ma
INTRODUCTION: Abdominal compartment syndrome (ACS) after endovascular repair (EVAR) of rupture abdominal aortic aneurysm (rAAA) is a rare emergency situation, which has a high mortality. However, the progression of ACS is rapid and the diagnosis is usually been delayed, which increase the difficulties in treatment and affect the prognosis. We describe a case of a sever complication (acute intestinal necrosis) resulting from ACS after endovascular repair of rAAA. CLINICAL FINDING: An elderly man, 81 years old, complained a sudden lower abdominal and back pain without any predisposing cause...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27873096/-experience-in-measuring-the-quality-of-treatment-in-interventional-pain-therapy-the-activity-index-on-a%C3%A2-touchscreen-pc
#9
A R Kirrstetter, C Brenig, M Gengenbacher, B Meier, A Ott, R Theiler
BACKGROUND: There is a growing interest in patient-related outcome measurement. In this field questionnaires on touch screens are becoming more common. This study was designed to identify problems in usability and feasibility of a web-based questionnaire. STUDY PARTICIPANTS AND METHODS: Patients who underwent a lumbar infiltration were recruited in 5 centers and 50 patients participated of which half were older than 62 years. One third of the patients had basically no former experience with computers or touch screens...
November 21, 2016: Der Schmerz
https://www.readbyqxmd.com/read/27867925/a-stable-secondary-gliosarcoma-with-extensive-systemic-metastases-a-case-report
#10
Tae-Min Choi, Young-Jun Cheon, Tae-Young Jung, Kyung-Hwa Lee
A 63-year-old man complained of intermittent motor weakness of his arm. The magnetic resonance image (MRI) of his brain displayed a high signal lesion in right cingulate gyrus on T2 weighted image. One year later, he showed a stuporous mental status with repeated seizures, and the follow-up brain MRI showed heterogeneously enhanced mass associated with bleeding. He was treated with surgery and radiotherapy for secondary glioblastomas in right cingulate gyrus. One year more later, a mass recurred on the left frontal base, and gliosarcoma was diagnosed...
October 2016: Brain Tumor Research and Treatment
https://www.readbyqxmd.com/read/27867079/variability-in-diagnostic-error-rates-of-ten-mri-centers-performing-lumbar-spine-mri-exams-on-the-same-patient-within-a-three-week-period
#11
Richard Herzog, Daniel R Elgort, Adam E Flanders, Peter J Moley
BACKGROUND CONTEXT: In today's healthcare climate, Magnetic Resonance Imaging (MRI) is often perceived as a commodity - a service where there are no meaningful differences in quality and thus an area in which patients can be advised to select a provider based on price and convenience alone. If this prevailing view is correct, then a patient should expect to receive the same radiological diagnosis regardless of which imaging center he or she visits or which radiologist reviews the examination...
November 17, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27866812/a-case-report-of-infectious-sacroiliitis-in-an-adult-presenting-to-the-emergency-department-with-inability-to-walk
#12
Douglas Brtalik, Manoj Pariyadath
BACKGROUND: Infectious sacroiliitis (ISI) is an uncommon cause of back and hip pain in which the sacroiliac joint, either unilateral or bilateral, is inflamed from an infectious source. Historically, this has been an easily missed diagnosis due to nonspecific presenting symptoms along with subtle nondistinguishable laboratory abnormalities. CASE REPORT: We describe an injection drug user presenting with right-sided ISI who presented with hip and back pain and inability to walk...
November 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27832792/gout-will-the-king-of-diseases-be-the-first-rheumatic-disease-to-be-cured
#13
EDITORIAL
Jasvinder A Singh
Gout is the most common inflammatory arthritis in adults in the Western world. Characterized by hyperuricemia and the effects of acute and chronic inflammation in joints and bursa, gout leads to an agonizing, chronically painful arthritis. Arthritis can also be accompanied by urate nephropathy and subcutaneous urate deposits (tophi). Exciting new developments in the last decade have brought back the focus on this interesting, crystal-induced chronic inflammatory condition. New insights include the role of NALP3 inflammasome-induced inflammation in acute gout, the characterization of diagnostic signs on ultrasound and dual-energy computed tomography imaging modalities, the recognition of target serum urate less than 6 mg/day as the goal for urate-lowering therapies, and evidence-based treatment guidelines...
November 11, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27827987/self-reported-ache-pain-or-numbness-in-feet-and-use-of-computers-amongst-working-age-finns
#14
Leena Korpinen, Rauno Pääkkönen, Fabriziomaria Gobba
The use of the computers and other technical devices has increased. The aim of our work was to study the possible relation between self-reported foot symptoms and use of computers and cell phones using a questionnaire. The study was carried out as a cross-sectional study by posting a questionnaire to 15,000 working-age Finns. A total of 6121 responded, and 7.1% of respondents reported that they very often experienced pain, numbness, and aches in the feet. They also often experienced other symptoms: 52.3% had symptoms in the neck, 53...
November 7, 2016: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/27822874/spinal-epidural-abscess-a-rare-complication-of-ulcerative-colitis-after-ileal-pouch-anal-anastomosis
#15
Mikio Kawamura, Toshimitsu Araki, Yoshiki Okita, Satoru Kondo, Takashi Ichikawa, Hiroyuki Fujikawa, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
BACKGROUND: Spinal epidural abscess is a rare condition with high morbidity and mortality, for which a delay in diagnosis and treatment can lead to irreversible neurologic deficit or even death. Although patients with spinal epidural abscess have systemic predisposing immunocompromised conditions, spinal intervention, or trauma, this condition has been reported as a result of perforation or fistulization arising from inflammatory bowel disease. We describe herein a rare case of spinal epidural abscess as a complication of ileal pouch anal anastomosis...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27822461/retroperitoneal-fibrosis-retrospective-descriptive-study-on-clinical-features-and-management
#16
Ann-Sophie Laroche, Robert Z Bell, Sarah Bezzaoucha, Eva Földes, Caroline Lamarche, Michel Vallée
INTRODUCTION: Retroperitoneal fibrosis (RPF) is a rare condition characterized by the presence of inflammatory and fibrous retroperitoneal tissue that often encases the ureters or abdominal organs. This study describes the clinical characteristics, diagnostic methods, and treatments and their effects on renal function. METHODS: We conducted a retrospective analysis of patients diagnosed with RPF at Maisonneuve-Rosemont Hospital. RESULTS: We identified 17 patients with RPF between 1998 and 2013...
2016: Research and Reports in Urology
https://www.readbyqxmd.com/read/27807780/retroperitoneal-haematoma-in-a-postoperative-alif-patient-taking-rivaroxaban-for-atrial-fibrillation
#17
Praveena Deekonda, Oliver M Stokes, Daniel Chan
BACKGROUND: Novel oral anticoagulants (NOACs) are being increasingly used in the secondary prevention of thromboembolic stroke in patients with atrial fibrillation. Patients taking NOACs are difficult to manage perioperatively, and several unexpected complications have been reported in these patients. CASE REPORT: We report a case of a rivaroxaban-induced retroperitoneal haematoma in a 72-year-old man who underwent an L5/S1 anterior lumbar interbody fusion (ALIF) for grade 1 spondylolytic spondylolisthesis...
November 2, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27806843/an-isolated-inflammatory-myofibroblastic-tumor-of-adrenal-gland
#18
Ghadah Al Sannaa, Jana L Wimmer, Alberto G Ayala, Jae Y Ro
Inflammatory myofibroblastic tumor (IMT) is an uncommon lesion that shows a wide range of anatomic distribution. The adrenal gland, however, is a distinctly rare site of occurrence. To date, only a few cases of IMT arising in the adrenal gland have been reported in the English literature. Here, we report another case of isolated adrenal IMT. A 34-year-old man presented to the emergency department with a complaint of a sudden severe right-sided back pain. Subsequent computed tomographic scan imaging studies demonstrated a large right adrenal mass associated with a hematoma...
December 2016: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/27803409/primary-mediastinal-large-b-cell-lymphoma-exhibiting-endobronchial-involvement
#19
Midori Shimada, Minoru Fukuda, Kensuke Horio, Takayuki Suyama, Takeshi Kitazaki, Kohji Hashiguchi, Masaaki Fukuda, Kazuto Shigematsu, Yoichi Nakamura, Takuya Honda, Kazuto Ashizawa, Hiroshi Mukae
Primary mediastinal large B-cell lymphoma (PMLBCL) is one of the subtypes of diffuse large B-cell lymphoma. We experienced a rare case of PMLBCL that exhibited endobronchial involvement. A 33-year-old Japanese female with the chief complaints of epigastralgia, back pain, and nausea visited a primary care hospital. Computed tomography of the chest and abdomen demonstrated a bulky mass in the left anterior mediastinum, multiple pulmonary nodules, axillary lymph node swelling, and a pancreatic tumor. Fiberoptic bronchoscopy showed a white-tinged irregularly shaped endobronchial tumor accompanied by capillary vessel dilation in the left upper lobar bronchus...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27792105/promis%C3%A2-pf-cat-outperforms-the-odi-and-sf-36-physical-function-domain-in-spine-patients
#20
Darrel S Brodke, Vadim Goz, Maren W Voss, Brandon D Lawrence, W Ryan Spiker, Hung Man
STUDY DESIGN: The Oswestry Disability Index v2.0 (ODI), SF36 Physical Function Domain (SF-36 PFD) and PROMIS Physical Function CAT v1.2 (PF CAT) questionnaires were prospectively collected from 1,607 patients complaining of back or leg pain, visiting a university-based spine clinic. All questionnaires were collected electronically, using a tablet computer. OBJECTIVE: To compare the psychometric properties of the PROMIS PF CAT to the ODI and SF36 Physical Function Domain in the same patient population...
October 27, 2016: Spine
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