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Diagnosis central pain

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https://www.readbyqxmd.com/read/28540905/tuberous-sclerosis-complex-bourneville-pringle-disease-in-a-25-year-old-female-with-bilateral-renal-angiomyolipoma-and-secondary-hypertension
#1
Sahar El Aoud, Faten Frikha, Mouna Snoussi, Raida Ben Salah, Zouhir Bahloul
Tuberous sclerosis or tuberous sclerosis complex (TSC) is an autosomal dominant inherited neurocutaneous disorder that variably affects the brain, skin, kidneys, heart, and other organs. It is characterized by skin and renal lesions in addition to central and peripheral nervous system tumors, with neurological and psychiatric findings. We report such a rare case of tuberous sclerosis in a 25-year-old female who presented with abdominal pain and hypertension. Physical examination showed dermatological signs that included hypopigmented maculae, shagreen plaque, angiofibromas on the centrofacial areas, periungual fibromas on toes, and molluscum pendulum around the neck...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28536341/-a-case-of-effective-chemoradiotherapy-using-mfolfox6-for-locally-advanced-rectal-cancer
#2
Yoshio Kuga, Shosuke Kitamura, Teruo Mouri, Tomohiro Miwata, Yuzoh Hirata, Yasuyo Ishizaki, Yasutoshi Hashimoto
We report a case of locally advanced rectal cancer, treated effectively with chemotherapy consisting of mFOLFOX6 combined with radiotherapy. A 63-year-old man was admitted to our hospital in March 2012 for diarrhea and anal and perineal pain. Advanced rectal cancer with invasion ofthe right perineum was diagnosed based on computer tomography(CT) findings. Surgery was performed; however, the rectal cancer was unresectable. A sigmoid colostomy was performed, and a central venous port was implanted. In April 2012, the patient was treated with chemotherapy using 3 courses ofmFOLFOX6 and concurrent radiotherapy...
May 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28535580/gastroparesis-updates-on-pathogenesis-and-management
#3
REVIEW
Nanlong Liu, Thomas Abell
Gastroparesis (Gp) is a chronic disease that presents with clinical symptoms of early satiety, bloating, nausea, vomiting, and abdominal pain. Along with these symptoms, an objective finding of delayed gastric emptying, along with a documented absence of gastric outlet obstruction, are required for diagnosis. This article focuses on updates in the pathogenesis and management of Gp. Recent studies on full thickness biopsies of Gp patients have shed light on the complex interactions of the central, autonomic, and enteric nervous systems, which all play key roles in maintaining normal gut motility...
May 25, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28532452/psychometric-properties-of-the-paindetect-questionnaire-in-rheumatoid-arthritis-psoriatic-arthritis-and-spondyloarthritis-rasch-analysis-and-test-retest-reliability
#4
Signe Rifbjerg-Madsen, Eva Ejlersen Wæhrens, Bente Danneskiold-Samsøe, Kirstine Amris
BACKGROUND: Pain is inherent in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA) and traditionally considered to be of nociceptive origin. Emerging data suggest a potential role of augmented central pain mechanisms in subsets of patients, thus, valid instruments that can identify underlying pain mechanisms are needed. The painDETECT questionnaire (PDQ) was originally designed to differentiate between pain phenotypes. The objectives were to evaluate the psychometric properties of the PDQ in patients with inflammatory arthritis by applying Rasch analysis and to explore the reliability of pain classification by test-retest...
May 22, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28527519/-adult-intramedullary-gliomas
#5
C Campello, F Parker, S Slimani, A Le Floch, A Herbrecht, N Aghakhani, C Lacroix, H Loiseau, J P Lejeune, G Perrin, J Honnorat, H Dufour, O Chinot, D Figarella, L Bauchet, H Duffau, M Lonjon, P Labauge, M Messerer, J P Daures, P Fabbro, B Ducot
OBJECTIVES: Intramedullary gliomas are rare tumors accounting for less than 4% of all primary central nervous system tumors. The aims of this retrospective multicenter study were to assess their natural outcome as well as management. METHODS AND MATERIALS: We studied 332 patients from 1984 to 2011. Histopathological examination revealed 72% ependymomas (94% were low grade tumors), 24% astrocytomas (29% were high grade tumors), 2.4% mixed gliomas and 1.7% oligodendrogliomas...
May 17, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28514220/case-242-radiation-induced-angiosarcoma
#6
Meredith Disharoon, Kamilia F Kozlowski, Jessica M Kaniowski
History In 2004, this woman received a diagnosis of invasive mammillary carcinoma, tubular variant, strongly positive for estrogen and progesterone receptors. Her lesion was found at screening mammography performed at an outside institution when she was 59 years old. She underwent partial mastectomy, with partial axillary node dissection and sentinel node mapping. A 0.6 × 0.5 cm Nottingham grade 1 infiltrating ductal carcinoma was removed from the right upper outer quadrant, margins were free of tumor, and there was no angiolymphatic invasion...
June 2017: Radiology
https://www.readbyqxmd.com/read/28512496/nonsurgical-management-of-a-large-periapical-lesion-a-case-report
#7
Sajedeh Ghorbanzadeh, Hengameh Ashraf, Sepanta Hosseinpour, Fatemeh Ghorbanzadeh
This case report describes the non-surgical management of a large cyst-like periapical lesion in the mandible of a 16-year-old female with the chief complaint of periodic swelling and pus drainage from the mandibular anterior region gingivae with no history of pain and traumatic accident in this area. Both mandibular central incisors had extensive caries. Root canals of both mandibular central incisors were filled with calcium hydroxide. After 10 days, endodontic therapy was carried out on both teeth. Clinical and radiographic re-evaluations at 3 and 12 months revealed progressing bone healing...
2017: Iranian Endodontic Journal
https://www.readbyqxmd.com/read/28509608/differential-diagnosis-and-recovery-of-acute-bilateral-foot-drop-in-a-patient-with-a-history-of-low-back-pain-a-case-report
#8
Melanie Lomaglio, Bob Canale
BACKGROUND AND PURPOSE: Acute bilateral foot drop is rare and may be due to peripheral or central lesions. The purpose of this case report was to describe the differential diagnosis and recovery of a patient with low back pain (LBP) that awoke with bilateral foot drop. CASE DESCRIPTION: A 39-year-old man with a history of LBP awoke with a steppage gait pattern. Spinal imaging and tapping were negative for sinister pathologies. A subsequent history taken by the physical therapist uncovered that the patient had previously taken a narcotic and slept in a kneeling position to relieve his LBP...
May 16, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28506404/-dural-sinus-thrombosis-following-epidural-analgesia-for-delivery-a-clinical-case
#9
Marco Aurelio Dornelles, Luis M Pereira
BACKGROUND AND OBJECTIVES: Neurological complications of spinal anesthesia are rare conditions. Headache caused by low pressure of the cerebrospinal fluid is one of the most frequent, which occurs after post-dural puncture. A comprehensive history and physical exam must be carried out before making the diagnosis of Post-Dural Puncture Headache (PDPH) and additional tests are necessary to exclude the possibility of developing serious neurological complications such as Dural Sinus Thrombosis (DST)...
May 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28503990/assessing-the-utilization-of-radiotherapy-near-end-of-life-at-a-finnish-university-hospital-a-retrospective-cohort-study
#10
Liisa K Rautakorpi, Johanna M Mäkelä, Fatemeh Seyednasrollah, Anna M Hammais, Tarja Laitinen, Outi M Hirvonen, Heikki Minn, Laura L Elo, Sirkku M Jyrkkiö
BACKGROUND: Palliative radiotherapy can improve quality of life for cancer patients during the last months of life. However, very short life expectancy may devastate the benefit of the treatment. This single center study assesses the utilization of radiotherapy during the last weeks of life. MATERIAL AND METHODS: All cancer patients (N = 38,982) treated with radiotherapy (N = 11,395) in Turku University Central Hospital during 2005-2013 were identified in the database consisting of electronic patient records...
May 13, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28502036/perceptions-of-painful-diabetic-peripheral-neuropathy-in-south-east-asia-results-from-patient-and-physician-surveys
#11
Rayaz A Malik, Emre Aldinc, Siew-Pheng Chan, Chaicharn Deerochanawong, Chii-Min Hwu, Raymond L Rosales, Chun-Yip Yeung, Koichi Fujii, Bruce Parsons
There are no data on physician-patient communication in painful diabetic peripheral neuropathy (pDPN) in the Asia-Pacific region. The objective of this study was to examine patient and physician perceptions of pDPN and clinical practice behaviors in five countries in South-East Asia. Primary care physicians and practitioners, endocrinologists, diabetologists, and patients with pDPN completed separate surveys on pDPN diagnosis, impact, management, and physician-patient interactions in Hong Kong, Malaysia, the Philippines, Taiwan, and Thailand...
May 13, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28499407/early-neurosyphilis-presenting-with-facial-palsy-and-an-oral-ulcer-in-a-patient-who-is-human-immunodeficiency-virus-positive-a-case-report
#12
Evangeline Njiru, Jamil Abdulkadir, Zipporah Kamuren, Gabriel Kigen
BACKGROUND: Neurosyphilis is the tertiary stage of Treponema pallidum infection that involves the central nervous system, which occurs within days or weeks after an initial syphilis infection, especially in immunocompromised patients. The diagnosis of neurosyphilis is quite challenging as it is uncommon and often presents with obscure symptoms since any organ system may be involved. CASE PRESENTATION: We describe a case of a 40-year-old African man who is human immunodeficiency virus positive with early neurosyphilis who presented with a stiff neck, headache, confusion, restlessness, and a left-sided chest pain; he did not respond to an empiric treatment of ceftriaxone and fluconazole for meningitis, and tramadol for headache...
May 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28499364/clinical-classification-in-low-back-pain-best-evidence-diagnostic-rules-based-on-systematic-reviews
#13
Tom Petersen, Mark Laslett, Carsten Juhl
BACKGROUND: Clinical examination findings are used in primary care to give an initial diagnosis to patients with low back pain and related leg symptoms. The purpose of this study was to develop best evidence Clinical Diagnostic Rules (CDR] for the identification of the most common patho-anatomical disorders in the lumbar spine; i.e. intervertebral discs, sacroiliac joints, facet joints, bone, muscles, nerve roots, muscles, peripheral nerve tissue, and central nervous system sensitization...
May 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28491301/short-and-long-term-results-of-an-inpatient-programme-to-manage-complex-regional-pain-syndrome-in-children-and-adolescents
#14
Giovanni Cucchiaro, Kevin Craig, Kerri Marks, Kristin Cooley, Thalitha Kay Black Cox, Jennifer Schwartz
The aim of this retrospective study was to determine whether an inpatient approach and the use of regional anaesthesia techniques can accelerate the recovery to normal functions in children with Complex Regional Pain Syndrome (CRPS). This study looked at the data of patients admitted to the rehabilitation unit with a diagnosis of CRPS from January 2010 to April 2015. Variables such as hospital stay, medications administered, regional anaesthesia procedures, changes in functional status prior to treatment and at the time of discharge, psychological evaluation and diagnosis were evaluated...
May 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28481836/sensitivity-of-the-dn4-in-screening-for-neuropathic-pain-syndromes
#15
Elizabeth G VanDenKerkhof, Larry Stitt, Alexander J Clark, Allan Gordon, Mary Lynch, Patricia K Morley-Forster, Howard J Nathan, Catherine Smyth, Cory Toth, Mark A Ware, Dwight E Moulin
OBJECTIVES: Several tools have been developed to screen for neuropathic pain. This study examined the sensitivity of the Douleur Neuropathique en 4 Questions (DN4) in screening for various neuropathic pain syndromes. METHODS: This prospective observational study was conducted in 7 Canadian academic pain centers between April 2008 and December 2011. All newly admitted patients (n=2199) were approached and 789 eligible participants form the sample for this analysis...
May 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28469335/pediatric-osteosarcoma-an-updated-review
#16
REVIEW
Shachi Jain Taran, Rakesh Taran, Nagraj B Malipatil
Osteosarcoma (OS), the most common type of primary malignant bone tumor, is defined by the presence of malignant mesenchymal cells producing osteoid or immature bone. The peak incidence of the most frequent type of OS, i.e., high-grade central OS, occurs in the second decade of life during the adolescent growth spurt. Most patients suffer from the pain and swelling in the involved region and, usually, seek medical attention. Diagnosis is carried out by conventional radiographs, computed tomography, and magnetic resonance image (MRI)...
January 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28462853/comparing-clinical-characteristics-and-outcomes-of-young-onset-and-late-onset-colorectal-cancer-an-international-collaborative-study
#17
Young Soo Rho, Marine Gilabert, Karol Polom, Archil Aladashvili, Katerina Kopeckova, Vera Megdanova, Niamh Coleman, Megan Greally, Daniele Marrelli, Franco Roviello, Ray McDermott, Veneta Petrova, Zhasmina Mihaylova, Zbynek Bortlicek, Jana Prausova, Gerald Batist, Laurent Azoulay, Petr Kavan
BACKGROUND: Compared with the general population, the incidence of young-onset (YO) colorectal cancer (CRC) is increasing. However, a significant knowledge gap exists in the clinical characteristics, treatment patterns, and outcomes for these patients. MATERIALS AND METHODS: Six international tertiary cancer centers conducted a retrospective study. Patients with YO CRC (aged 18-44 years) and LO CRC (aged > 44 years) diagnosed with histologically proven colorectal adenocarcinoma from June 2003 to June 2014 were enrolled...
March 21, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28458723/controversies-and-challenges-in-fibromyalgia-a-review-and-a-proposal
#18
REVIEW
Helen Cohen
Fibromyalgia (FM) is the most commonly encountered chronic widespread pain (CWP) condition in rheumatology. In comparison to inflammatory arthritis (IA), it can seem ill defined with no clear understanding of the pathology and therefore no specific targeted treatment. This inevitably raises controversies and challenges. However, this is an outdated view perpetuated by poor teaching of pain at undergraduate and postgraduate levels, and the perennial problem of advances in relevant cross-speciality knowledge penetrating speciality silos...
May 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28450230/metastatic-alveolar-soft-part-sarcoma-of-the-spinal-cord-a-case-report-and-review-of-literature
#19
Michael J Randazzo, Jayesh P Thawani, Rashmi Manur, John S Brooks, Ali K Ozturk
BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare, malignant soft-tissue neoplasm typically seen in young adults that possesses an unusual tendency to metastasize. Metastases to the intramedullary compartment of the spinal cord, however, are exceptionally rare and have not been described in the literature. CASE DESCRIPTION: We report the case of a 23-year-old woman with disseminated ASPS to the lung and brain who presented with progressive lower extremity weakness and loss of sensation following radiation and chemotherapy...
April 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28444695/exercise-therapy-for-chronic-fatigue-syndrome
#20
REVIEW
Lillebeth Larun, Kjetil G Brurberg, Jan Odgaard-Jensen, Jonathan R Price
BACKGROUND: Chronic fatigue syndrome (CFS) is characterised by persistent, medically unexplained fatigue, as well as symptoms such as musculoskeletal pain, sleep disturbance, headaches and impaired concentration and short-term memory. CFS presents as a common, debilitating and serious health problem. Treatment may include physical interventions, such as exercise therapy, which was last reviewed in 2004. OBJECTIVES: The objective of this review was to determine the effects of exercise therapy (ET) for patients with CFS as compared with any other intervention or control...
April 25, 2017: Cochrane Database of Systematic Reviews
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