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https://www.readbyqxmd.com/read/27923204/case-report-of-the-surgical-management-of-small-bowel-and-colonic-ischaemia-associated-with-anorexia-nervosa-binge-purge-subtype
#1
Ann T Foran, Cillian Clancy, Tom F Gorey
INTRODUCTION: Anorexia Nervosa affects up to 1% of the population and can present with binge/purge episodes. A paucity of literature exists regarding small bowel and colonic ischaemia relating to this common condition. We report our own experience and management of a patient with anorexia nervosa binge/purge subtype with small bowel and colon ischaemia and review existing cases in the literature. PRESENTATION OF CASE: A 32year old female self-presented to the emergency department complaining of abdominal pain, abdominal distension and vomiting on a background history of binge/purge subtype eating disorder, following consumption of a large amount of carbohydrates...
August 25, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27921277/surgery-for-acute-exacerbation-of-chronic-mesenteric-ischemia-a-case-report
#2
Shinji Abe, Tomoji Yamakawa, Hideaki Kawashima, Makoto Yoshida, Setsuji Takanashi, Motoya Kashiyama, Masahiro Ishigooka, Yasushige Shingu, Yoshiro Matsui
BACKGROUND: Chronic mesenteric ischemia (CMI) is a rare disease; however, symptomatic CMI has a risk of acute exacerbation without timely revascularization. CASE PRESENTATION: A 54-year-old man who had had postprandial pain for 6 months was admitted to our hospital because of vomiting and diarrhea. Although the celiac and superior mesenteric arteries were occluded at the proximal portion, contrast enhancement of the bowel wall was good in contrast-enhanced computed tomography (CECT)...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27921113/-musculoskeletal-related-chest-pain
#3
C Sturm, T Witte
BACKGROUND: Approximately 10-50% of chest pains are caused by musculoskeletal disorders. The association is twice as frequent in primary care as in emergency admissions. AIM: This article provides an overview of the most important musculoskeletal causes of chest pain and on the diagnostics and therapy. METHODS: A selective search and analysis of the literature related to the topic of musculoskeletal causes of chest pain were carried out. RESULTS AND CONCLUSION: Non-inflammatory diseases, such as costochondritis and fibromyalgia are frequent causes of chest pain...
December 5, 2016: Der Internist
https://www.readbyqxmd.com/read/27920845/the-great-imitator-igg4-periaortitis-masquerading-as-an-acute-aortic-syndrome-on-computed-tomographic-angiography
#4
Drew W Moore, Neil J Hansen, Dominick J DiMaio, William L Harrison
We present the case of a 52-year-old woman who presented to the emergency department with chest and neck pain. Initial cervical spine magnetic resonance imaging shows an abnormal flow void in the left vertebral artery, which prompted a computed tomographic angiogram. This demonstrated a hyperdense thickened ascending aortic wall, which extended into the great vessel origins. Clinically and radiographically interpreted as an acute aortic syndrome and/or intramural hematoma, the patient underwent ascending aortic repair with graft...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920694/pancreatic-and-hepatic-metastasis-of-an-undiagnosed-choriocarcinoma-an-exceptional-cause-of-haemoperitoneum-in-young-women-report-of-a-rare-case
#5
Nishat Fatema, Neeru Vinod Arora, Fatma Majid Al Abri, Yaseer Muhammad Tareq Khan
Haemoperitoneum in women of reproductive age usually suggests either ruptured ectopic pregnancy or ruptured ovarian cysts. Metastatic choriocarcinoma is considered the least common cause of haemoperitoneum in women of childbearing age. We report a rare case of pancreatic and hepatic metastasis of choriocarcinoma in a young, 30-year-old female who had delivered 10 months prior at term gestation with no previous history of gestational trophoblastic disease or molar pregnancy. She had a short history of fever and pain in the right hypochondrium, with findings of hypovolaemic shock due to intraperitoneal haemorrhage...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920243/between-the-flags-implementing-a-safety-net-system-at-scale-to-recognise-and-manage-deteriorating-patients-in-the-new-south-wales-public-health-system
#6
Charles Pain, Malcolm Green, Colette Duff, Deborah Hyland, Annette Pantle, Kimberley Fitzpatrick, Cliff Hughes
QUALITY PROBLEM: In 2005, the Clinical Excellence Commission (CEC) found that unrecognised patient deterioration remained an important problem in New South Wales (NSW) public hospitals. INITIAL ASSESSMENT: The challenge was to design and implement an effective and sustainable safety-net system in all 225 NSW public hospitals. DESIGNING A SOLUTION: The CEC's system was designed in collaboration with a broad coalition of partners, including clinicians, managers, system administrators and collaborating agencies...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27920228/exploring-novel-paths-towards-protein-signatures-of-chronic-pain
#7
David Gomez-Varela, Manuela Schmidt
Pain is a major symptom of many medical conditions and the worldwide number one reason for people to seek medical assistance. It affects the quality of life of patients and poses a heavy financial burden on society with high costs of treatment and lost productivity. Furthermore, the treatment of chronic pain presents a big challenge as pain therapeutics often lack efficacy and exhibit minimal safety profiles. The latter can be largely attributed to the fact that current therapies target molecules with key physiological functions throughout the body...
2016: Molecular Pain
https://www.readbyqxmd.com/read/27919865/shared-decision-making-in-patients-with-low-risk-chest-pain-prospective-randomized-pragmatic-trial
#8
Erik P Hess, Judd E Hollander, Jason T Schaffer, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Nilay D Shah, Jonathan Inselman, Jeph Herrin, Ana Castaneda-Guarderas, Victor M Montori
OBJECTIVE:  To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. DESIGN:  Multicenter pragmatic parallel randomized controlled trial. SETTING:  Six emergency departments in the United States. PARTICIPANTS:  898 adults (aged >17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring for patients with chest pain...
December 5, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27919776/state-versus-trait-validating-state-assessment-of-child-and-parental-catastrophic-thinking-about-children-s-acute-pain
#9
Hannah Durand, Kathryn A Birnie, Melanie Noel, Tine Vervoort, Liesbet Goubert, Katelynn E Boerner, Christine T Chambers, Line Caes
: Pain catastrophizing has emerged as one of the most robust predictors of child pain outcomes. Although assessments of state (i.e., situation-specific) pain catastrophizing in children and parents are often used, their psychometric properties are unknown. This study aimed to assess factor structure, reliability and predictive validity of state versions of Pain Catastrophizing Scales for children (PCS-C State) and parents (PCS-P State) relative to corresponding trait versions for child and parental pain-related outcomes...
December 2, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27919773/analgesic-effects-of-alcohol-a-systematic-review-and-meta-analysis-of-controlled-experimental-studies-in-healthy-participants
#10
REVIEW
Trevor Thompson, Charlotte Oram, Christoph U Correll, Stella Tsermentseli, Brendon Stubbs
: Despite the long-standing belief in the analgesic properties of alcohol, experimental studies have produced mixed results. This meta-analysis aimed to clarify whether alcohol produces a decrease in experimentally-induced pain and to determine the magnitude of any such effect. PubMed, PsycINFO and Embase databases were searched from inception until 21/4/2016 for controlled studies examining the effect of quantified dosages of alcohol on pain response to noxious stimulation. Eighteen studies involving 404 participants were identified providing alcohol vs...
December 2, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27919449/nonsteroidal-anti-inflammatory-drugs-may-affect-cytokine-response-and-benefit-healing-of-combat-related-extremity-wounds
#11
Felipe A Lisboa, Matthew J Bradley, Matthew T Hueman, Seth A Schobel, Beverly J Gaucher, Edda L Styrmisdottir, Benjamin K Potter, Jonathan A Forsberg, Eric A Elster
BACKGROUND: After adequate operative debridement and antimicrobial therapies, combat-related extremity wounds that either heal or fail are both associated with a distinct inflammatory response. Short-term use of nonsteroidal anti-inflammatory drugs in postoperative pain management may affect this response and, by consequence, the healing potential of these wounds. We investigated whether patients treated with nonsteroidal anti-inflammatory drugs had a distinct inflammatory response; different rates of critical colonization, defined as >10(5) colony forming units on quantitative bacteriology; and healing potential...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27919369/informing-the-development-of-an-internet-based-chronic-pain-self-management-program
#12
Amédé Gogovor, Regina Visca, Claudine Auger, Lucie Bouvrette-Leblanc, Iphigenia Symeonidis, Lise Poissant, Mark A Ware, Yoram Shir, Natacha Viens, Sara Ahmed
BACKGROUND: Self-management can optimize health outcomes for individuals with chronic pain (CP), an increasing fiscal and social burden in Canada. However, self-management is rarely integrated into the regular care (team activities and medical treatment) patients receive. Health information technology offers an opportunity to provide regular monitoring and exchange of information between patient and care team. OBJECTIVE: To identify information needs and gaps in chronic pain management as well as technology features to inform the development of an Internet-based self-management program...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919348/hdl-function-is-impaired-in-acute-myocardial-infarction-independent-of-plasma-hdl-cholesterol-levels
#13
Wijtske Annema, Hendrik M Willemsen, Jan Freark de Boer, Arne Dikkers, Markus van der Giet, Wybe Nieuwland, Anneke C Muller Kobold, L Joost van Pelt, Riemer H J A Slart, Iwan C C van der Horst, Robin P F Dullaart, René A Tio, Uwe J F Tietge
BACKGROUND: High-density lipoproteins (HDLs) protect against the development of atherosclerotic cardiovascular disease. HDL function represents an emerging concept in cardiovascular research. OBJECTIVE: This study investigated the association between HDL functionality and acute myocardial infarction (MI) independent of HDL-cholesterol plasma levels. METHODS: Participants (non-ST-segment elevation MI, non-STEMI, n = 41; STEMI, n = 37; non-MI patients, n = 33) from a prospective follow-up study enrolling patients with acute chest pain were matched for age and plasma HDL cholesterol...
November 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27919222/capsaicin-8-patch-repeat-treatment-plus-standard-of-care-soc-versus-soc-alone-in-painful-diabetic-peripheral-neuropathy-a-randomised-52-week-open-label-safety-study
#14
Aaron I Vinik, Serge Perrot, Etta J Vinik, Ladislav Pazdera, Hélène Jacobs, Malcolm Stoker, Stephen K Long, Robert J Snijder, Marjolijne van der Stoep, Enrique Ortega, Nathaniel Katz
BACKGROUND: This 52-week study evaluated the long-term safety and tolerability of capsaicin 8% w/w (179 mg) patch repeat treatment plus standard of care (SOC) versus SOC alone in painful diabetic peripheral neuropathy (PDPN). METHODS: Phase 3, multinational, open-label, randomised, controlled, 52-week safety study, conducted in Europe. Patients were randomised to capsaicin 8% patch repeat treatment (30 or 60 min; 1-7 treatments with ≥ 8-week intervals) to painful areas of the feet plus SOC, or SOC alone...
December 6, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27919177/economic-burden-of-inadequate-symptom-control-among-us-commercially-insured-irritable-bowel-syndrome-patients-with-diarrhea
#15
Jessica L Buono, Kush Mathur, Amelia J Averitt, David A Andrae
AIMS: To assess healthcare resource use and costs among irritable bowel syndrome (IBS) with diarrhea (IBS-D) patients with and without evidence of inadequate symptom control on current prescription therapies and estimate incremental all-cause costs associated with inadequate symptom control. METHODS: IBS-D patients aged ≥18 years with ≥1 medical claim for IBS (ICD-9-CM 564.1x) and either ≥2 claims for diarrhea (ICD-9-CM 787.91, 564.5x), or ≥1 claim for diarrhea plus ≥1 claim for abdominal pain (ICD-9-CM 789...
December 6, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27918377/utility-of-emergency-department-observation-units-for-neurologically-intact-children-with-head-ct-abnormalities-secondary-to-acute-closed-head-injury
#16
Roxanna Lefort, Jill V Hunter, Andrea T Cruz, A Chantal Caviness, Thomas G Luerssen, Aderonke Adekunle-Ojo
OBJECTIVE: The aim of the study was to evaluate the utility of the emergency department observation unit (EDOU) for neurologically intact children with closed head injuries (CHIs) and computed tomography (CT) abnormalities. METHODS: A retrospective cohort study of children aged 0 to 18 years with acute CHI, abnormal head CT, and a Glasgow Coma Scales score of 14 or higher admitted to the EDOU of a tertiary care children's hospital from 2007 to 2010. Children with multisystem trauma, nonaccidental trauma, and previous neurosurgical or coagulopathic conditions were excluded...
December 1, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27918315/the-gut-microbiota-as-a-key-regulator-of-visceral-pain
#17
Siobhain M O' Mahony, Timothy G Dinan, John F Cryan
Visceral pain is a significant and prevalent feature of several disorders including the functional gastrointestinal disorder, irritable bowel syndrome (IBS). Treatment strategies are limited and often unsatisfactory which has opened up new research avenues into the aetiology of visceral pain. This research has led to an increased appreciation of the role of the brain gut axis in modulating viscera pain responses. More recently, the interactions between the gut microbiota and the central nervous system have emerged indicating that visceral pain related disorders may be prospective candidates for symptom relief via microbial manipulation...
November 29, 2016: Pain
https://www.readbyqxmd.com/read/27916937/the-emergence-and-epidemiology-of-haff-disease-in-china
#18
REVIEW
Thomas Y K Chan
Haff disease is a rare syndrome of unexplained myalgia and rhabdomyolysis occurring within 24 h of consumption of certain types of cooked freshwater fish or crustacean. It is caused by a yet unidentified heat-stable toxin. In the present review of published case studies and official press releases, the main objective is to report the emergence and epidemiology of Haff disease in China. Haff disease first occurred in Beijing in 2000 and in Lianzhou and Liannan, Guangdong Province in 2009. Subsequent outbreaks mostly occurred in the Jiangsu Province-Nanjing, Yangzhou, Huai'an, and Yancheng...
December 1, 2016: Toxins
https://www.readbyqxmd.com/read/27915446/superior-dislocation-of-the-patella-a-pathognomonic-finding-and-review-of-literature
#19
P W van Egmond, M C Vermeulen, C F van Dijke, H C A Graat
A 59-year-old woman with a painful right knee that became locked in extension after a trivial trauma was seen at the emergency room. This was caused by unloaded hyperextension in bed. She was diagnosed with a superior dislocation of the patella. A closed reduction was performed, but a recurrent episode was seen within a week. An arthroscopy was performed, in which the causative osteophytes were removed. In the 12-month follow-up after treatment, no recurrence was seen. A superior dislocation of the patella is caused by patellofemoral osteophytes that interlock...
December 3, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27914655/crohn-s-disease
#20
REVIEW
Joana Torres, Saurabh Mehandru, Jean-Frédéric Colombel, Laurent Peyrin-Biroulet
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide. Crohn's disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The typical clinical scenario is a young patient presenting with abdominal pain, chronic diarrhoea, weight loss, and fatigue. Assessment of disease extent and of prognostic factors for complications is paramount to guide therapeutic decisions...
November 30, 2016: Lancet
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