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https://www.readbyqxmd.com/read/28743149/-the-influence-of-anesthesia-on-perioperative-outcome-in-children-institutional-and-individual-factors
#1
Frank Fideler, Christian Grasshoff
The perioperative care of children is challenging for health care providers. Since anesthetists cannot affect the nature of the disease and have hardly an impact on the decision for surgery we summarized in this review individual and institutional factors for improving perioperative outcome by anesthetists. Individual factors include the level of education and the professional experience of the anesthetist as well as an anesthetic management that is focused on the maintenance of an adequate cerebral perfusion...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#2
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742646/comparison-of-3-symptom-classification-methods-to-standardize-the-history-component-of-the-heart-score
#3
Michael R Marchick, Michael L Setteducato, Jesse J Revenis, Matthew A Robinson, Emily C Weeks, Thomas F Payton, David E Winchester, Brandon R Allen
OBJECTIVES: The History, Electrocardiography, Age, Risk factors, Troponin (HEART) score enables rapid risk stratification of emergency department patients presenting with chest pain. However, the subjectivity in scoring introduced by the history component has been criticized by some clinicians. We examined the association of 3 objective scoring models with the results of noninvasive cardiac testing. METHODS: Medical records for all patients evaluated in the chest pain center of an academic medical center during a 1-year period were reviewed retrospectively...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742643/sensitive-troponin-i-and-stress-testing-in-the-emergency-department-for-the-early-management-of-chest-pain-using-2-hour-protocol
#4
Shahriar Dadkhah, Zakaria Almuwaqqat, Samian Sulaiman, Husein Husein, Quang Nguyen, Saad Ali, Tuncay Taskesen
BACKGROUND: Despite improvements in identifying high-risk patients with non-ST segment ACS (acute coronary syndrome), low risk patients presenting with atypical chest pain and non-diagnostic Electrocardiogram (ECG) continued to undergo unnecessary admissions and testing. Since 1992, our chest pain protocol included using 4-hour serial biomarkers from ED admission in combination with stress testing to evaluate these patients. Our study aimed at determining whether a new accelerated diagnostic protocol using sensitive cardiac troponin I (cTnI) 2 hours after admission to the ED followed by stress testing is safe and effective in emergency settings, allowing for appropriate triage, earlier discharge and reducing costs...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742401/chikungunya-virus-seroprevalence-and-associated-factors-among-hospital-attendees-in-two-states-of-southwest-nigeria-a-preliminary-assessment
#5
Olayinka M Olajiga, Olajumoke E Adesoye, Adewale P Emilolorun, Abiodun J Adeyemi, Emmanuel O Adeyefa, Ismail A Aderibigbe, Salmot A Adejumo, Wasiu O Adebimpe, Oluyinka O Opaleye, Waidi F Sule, Daniel O Oluwayelu
Chikungunya virus (CHIKV) is a re-emerging pathogen causing long-term polyarthritis and encephalitis. In conducting a preliminary investigation, we hypothesized that there is no serologic evidence of CHIKV infection among attendees of selected hospitals in Lagos and Osun States, Nigeria. Sera from 304 consecutively selected participants were screened for CHIKV IgG and IgM using ELISA. Findings were analyzed vis-à-vis participants' demographic and clinical data. Over 90.0% of the participants had never heard of CHIKV despite the fact that a large proportion of them (88...
July 25, 2017: Immunological Investigations
https://www.readbyqxmd.com/read/28742306/identifying-emergency-department-patients-with-chest-pain-who-are-at-low-risk-for-acute-coronary-syndromes-digest
#6
David Markel, Jeremy Kim
Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes,identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing...
July 21, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28740997/guidelines-for-bystander-first-aid-2016
#7
Jen Heng Pek
Cardiac life support is a form of first aid for cardiac emergencies. However, research and evidence in this field is lacking compared with other forms of first aid. Having identified the common emergencies that are encountered in the hospital, based on the available evidence, we have put together what could be an evidence-based approach to the first aid management of some of these common emergencies, viz. breathlessness, chest pain, allergies, stroke, heat injury, poisoning, unconsciousness, seizures, and trauma situations such as bleeding, wounds, contusions, head injury, burns and fractures...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740693/disease-flare-after-discontinuing-gefitinib-in-a-patient-with-lung-adenocarcinoma-and-concomitant-epithelial-growth-factor-receptor-mutation-and-anaplastic-lymphoma-kinase-translocation
#8
Eun Hye Park, Hwa Young Lee, Jin Woo Kim, Chang Dong Yeo
We report on a patient with lung adenocarcinoma and a concomitant epithelial growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) translocation who developed a disease flare after discontinuing gefitinib. A 63-year-old woman with lung adenocarcinoma and a concomitant activating EGFR mutation and ALK translocation was treated with first-line gefitinib. After 4 months, she discontinued the gefitinib due to disease progression. She was admitted to the emergency room complaining of severe dyspnea and back pain 22 days after discontinuing gefitinib...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740427/vulvodynia-is-not-created-equally-empirical-classification-of-women-with-vulvodynia
#9
Meryl Alappattu, Georgine Lamvu, Jessica Feranec, Kathryn Witzeman, Michael Robinson, Andrea Rapkin
BACKGROUND: Vulvodynia classification is based on the sensory dimensions of pain and does not include psychological factors associated with the pain experience and treatment outcomes. Previous work has shown that individuals with chronic pain can be classified into subgroups based on pain sensitivity, psychological distress, mood, and symptom severity. OBJECTIVE: The aim of this study was to identify distinct subgroups of women with vulvodynia enrolled in the National Vulvodynia Registry...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28739614/apical-ballooning-takotsubo-syndrome-with-concurrent-st-segment-elevation-myocardial-infarction
#10
Mohsin A Hussain, Andrew T Cox, Rachel Bastiaenen, Abhiram Prasad
We present the case of a 61-year-old woman admitted with chest pain and an ECG demonstrating ST-segment elevation in the lateral leads. Emergency coronary angiography demonstrated an occluded obtuse marginal branch. Percutaneous intervention was unsuccessful as the lesion could not be crossed with a wire. Left ventriculography and transthoracic echocardiography demonstrated hypokinesis of the entire apex but preserved contractility of the basal segments, consistent with a diagnosis of apical ballooning syndrome (ABS)...
July 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28739461/perforator-vein-access-for-venous-pharmacomechanical-thrombolysis
#11
Afsha Aurshina, Arkady Ganelin, Anil Hingorani, Borislav Kheyson, Natalie Marks, Enrico Ascher
A 28-year-old Hispanic female with a history of deep vein thrombosis presented to the emergency room with left lower extremity swelling and pain. On duplex venous exam, an extensive left lower extremity DVT extending to her left common iliac vein was identified. A perforator vein measuring 2.6 mm located in the mid-calf area was used to access and perform mechanical and chemical thrombolysis. Complete resolution of symptoms was observed.
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739400/intraoperative-and-postoperative-pain-in-cataract-surgery
#12
REVIEW
Jed H Assam, Ashlie Bernhisel, Amy Lin
Technologic improvements in cataract surgery have not only improved visual outcomes, but also have minimized intraoperative and postoperative pain. We review the mechanisms, risk factors, and management of intraoperative and postoperative pain. Summaries of less common sources of physiologic pain have been included to reinforce recognition of when pain represents an expected physiologic reaction to surgery as opposed to signaling a more serious complication. We also discuss various current and emerging anesthetic and analgesic modalities...
July 21, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28739258/inhibition-by-divalent-metal-ions-of-human-histidine-triad-nucleotide-binding-protein1-hhint1-a-regulator-of-opioid-analgesia-and-neuropathic-pain
#13
Rachit Shah, Tsui-Fen Chou, Kimberly M Maize, Alexander Strom, Barry C Finzel, Carston R Wagner
Human histidine triad nucleotide binding protein 1 (hHint1) is a purine nucleoside phosphoramidase and adenylate hydrolase that has emerged as a potential therapeutic target for the management of pain. However the molecular mechanism of Hint1 in the signaling pathway has remained less clear. The role of metal ions in regulating postsynaptic transmission is well known, and the active site of hHint1 contains multiple histidines. Here we have investigated the effect of divalent metal ions (Cd(2+), Cu(2+), Mg(2+), Mn(2+), Ni(2+), and Zn(2+)) on the structural integrity and catalytic activity of hHint1...
July 21, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28738298/laparoscopic-treatment-of-dunbar-syndrome-a-case-report
#14
Orlando Jorge M Torres, Ozimo Pereira Gama-Filho, Camila Cristina Salazar Torres, Ricardo Mary Medeiros, Caio Márcio Barros Oliveira
BACKGROUND: Dunbar syndrome is a rare disorder due to external compression of the celiac trunk by the median arcuate ligament. The symptoms include abdominal pain, nausea and vomiting. Laparoscopic treatment was suggested as a safe procedure. The aim of this study is to present a case of Dunbar syndrome underwent laparoscopic treatment. CASEPRESENTATION: A 17-year-old female patient presented at emergency room with upper abdominal pain and dyspepsia, related to food intake...
July 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28738239/delayed-graft-duodenal-perforation-due-to-impacted-food-five-years-after-simultaneous-pancreas-kidney-transplantation-a-case-report
#15
Taizo Sakata, Hideki Katagiri, Tadao Kubota, Takashi Sakamoto, Kentaro Yoshikawa, Alan Kawarai Lefor, Cheol Woong Jung, Toru Kojima
INTRODUCTION: Pancreas transplantation is the best treatment option in selected patients with type 1 diabetes mellitus. Here we report a patient with a nonmarginal duodenal perforation five years after a simultaneous pancreas-living donor kidney transplantation (SPLKT). PRESENTATION OF CASE: A 31-year old male who underwent SPLKT five years previously presented with severe abdominal pain. He had a marginal duodenal perforation four years later, treated by primary closure and drainage...
July 14, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28738106/predictors-of-clinically-significant-outcome-for-adolescents-with-temporomandibular-disorders
#16
Kerstin Wahlund, Bo Larsson
AIMS: To evaluate and identify baseline characteristics of the adolescent patients included in two previous randomized controlled trials (RCTs) that may predict a clinically significant outcome after treatment of temporomandibular disorders (TMD) with an occlusal appliance (OA) or relaxation training (RT) in a clinical sample of adolescents. METHODS: This study combined two patient samples from the earlier RCTs for a total of 167 adolescents with frequent TMD pain (once a week or more often), diagnosed according to the Research Diagnostic Criteria for TMD...
July 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/28737876/-acute-pericarditis-complicated-by-pericardial-effusion-in-a-pediatric-patient-case-report
#17
Daniel Palanca Arias, Elena G Corella Aznar, Ariadna Ayerza Casas, Alba Fernández Gómez, Marta López Ramón, Lorenzo Jiménez Montañés
Acute pericarditis is the most common disease of the pericardium encountered in clinical practice. It is diagnosed in 0.1% of all admissions and 5% of emergency room admissions for chest pain. In developed countries, it is usually due to a benign cause. Idiopathic and infectious pericarditis are more common than secondary to surgical pericardiotomy or neoplastic causes, whereas tuberculosis is the dominant cause in developing countries. The most common symptoms of pericarditis are characteristic chest pain and fever...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28737670/motor-control-training-for-the-shoulder-with-smart-garments
#18
Qi Wang, Liesbet De Baets, Annick Timmermans, Wei Chen, Luca Giacolini, Thomas Matheve, Panos Markopoulos
Wearable technologies for posture monitoring and posture correction are emerging as a way to support and enhance physical therapy treatment, e.g., for motor control training in neurological disorders or for treating musculoskeletal disorders, such as shoulder, neck, or lower back pain. Among the various technological options for posture monitoring, wearable systems offer potential advantages regarding mobility, use in different contexts and sustained tracking in daily life. We describe the design of a smart garment named Zishi to monitor compensatory movements and evaluate its applicability for shoulder motor control training in a clinical setting...
July 22, 2017: Sensors
https://www.readbyqxmd.com/read/28737582/a-nutritional-approach-for-managing-irritable-bowel-syndrome
#19
Natalie Bhesania, Gail A M Cresci
PURPOSE OF REVIEW: Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder (FGID) encountered by the pediatrician and consultant. The primary focus of this review is to provide an update on beneficial nutritional interventions for managing this patient population with discussion on gut microbiome effects. RECENT FINDINGS: A common complaint among the pediatric population is IBS-related recurrent abdominal pain. The prevalence of IBS is estimated to range between 6 and 14% and is defined by the Rome III criteria for FGIDs...
July 21, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28737198/-tetany-secondary-to-phosphate-enema-toxicity-case-report
#20
María José Núñez Sánchez, Sofía Leighton Swaneck, Franco Díaz
Phosphate enemas are frequently used in the treatment of constipation. Errors in dosage and administration can lead to severe complications. OBJECTIVE: To report a case of severe toxicity of phosphate enemas in a child with no risk factors. CASE: 2 years old female, with functional constipation, was brought to emergency department because abdominal pain. She was diagnosed with fecal impaction and received half a bottle of Fleet Adult® (Laboratorio Synthon, Chile) two times, with no clinical resolution, deciding to start proctoclisis in pediatric ward...
June 2017: Revista Chilena de Pediatría
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