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https://www.readbyqxmd.com/read/29334488/severe-intraocular-pressure-elevation-after-intracameral-healon-5-viscoelastic-support-for-post-operative-hypotony-after-xen-gel-stent-insertion
#1
Alice Bruynseels, Freda Sii, Imran Masood, Peter Shah
PURPOSE: To describe (i) a novel case of severe intraocular pressure (IOP) elevation due to intracameral Healon 5 for management of early post-operative hypotony following XEN Gel Stent insertion and (ii) the management of this complication. METHODS: A case report. RESULTS: A 52-year-old male, with primary open angle glaucoma and suboptimal left IOP control on maximally tolerated medical therapy, was managed with XEN Gel Stent insertion at another tertiary eye unit...
January 12, 2018: Journal of Glaucoma
https://www.readbyqxmd.com/read/29333809/assessment-of-orofacial-pain-management-in-a-pediatric-emergency-department-and-at-home-after-discharge
#2
Yurena Aguilar de la Red, Gema Manrique Martín, Gloria Guerrero López, Concepción González Herrero, Paula López Vázquez, Concepción Míguez Navarro
INTRODUCTION: An inadequate pain management is common in the emergency department. Our objective was to analyze pain management among children with an orofacial infection or trauma in the emergency department and to assess compliance and satisfaction with analgesia prescribed at discharge. POPULATION AND METHODS: Cross-sectional, observational and analytical study in children attending the emergency department for an orofacial infection or trauma over 2 months. Pain management in the emergency department, analgesia prescribed at home and, following a call to parents, treatment provided and its adequacy to control pain were registered...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29333014/is-colorectal-cancer-in-young-40-years-different-from-those-in-the-elderly-40-years-experience-from-a-regional-care-center
#3
Rudresha A Haleshappa, Suparna Ajit Rao, Sunny Garg, C Lakshmaiah Kuntegowdanahalli, Govinda Babu Kanakasetty, Lokanatha Dasappa
Background: Colorectal cancer (CRC) is considered a disease of elderly. There has been a steady decrease in the incidence in those aged >50 years, with an alarming increase noted in adults aged <50 years. Subjects and Methods: We retrospectively analyzed 89 patients diagnosed with CRC aged <40 years between the years 2010 and 2014. Their clinical profile, treatment, and outcomes were studied. Results: The median age was 33 years with a male preponderance (56...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29332433/slippage-of-tightrope-button-in-syndesmotic-fixation-of-weber-c-malleolar-fractures-a-case-series
#4
Mas'uud Ibnu Samsudin, Ming Quan Wayne Yap, Ang Wei Luong, Ernest Beng Kee Kwek
BACKGROUND: Tightrope fixation is an emerging technique for syndesmotic fixation with promising results. However, our case series highlights the slippage of Tightrope buttons as a complication of suture button syndesmotic fixation of Weber C malleolar fractures using limited contact dynamic compression (LCDCP) plates. METHODS: We report a series of cases from our database in which slippage of the Tightrope button through the LCDCP holes in Weber C malleolar fractures was noted...
January 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29332237/acute-acetaminophen-ingestion-improves-performance-and-muscle-activation-during-maximal-intermittent-knee-extensor-exercise
#5
Paul T Morgan, Joanna L Bowtell, Anni Vanhatalo, Andrew M Jones, Stephen J Bailey
AIM: Acetaminophen is a commonly used medicine for pain relief and emerging evidence suggests that it may improve endurance exercise performance. This study investigated some of the physiological mechanisms by which acute acetaminophen ingestion might blunt muscle fatigue development. METHODS: Thirteen active males completed 60 × 3 s maximum voluntary contractions (MVC) of the knee extensors with each contraction separated by a 2 s passive recovery period...
January 13, 2018: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/29330975/emergency-inguinal-hernia-repair-comparison-of-desarda-s-versus-darning-technique
#6
Adeel Hussain, Syed Mehsam, Mansab Ali, Shahid Rasul, Sughra Parveen, Ahson Memon
BACKGROUND: Emergency inguinal hernia repair remains the commonest operation performed by general surgeons all over the world. The aim of this study was to compare the mean operative time, post-operative pain, wound infection and early recurrence between Desarda's and Darning emergency inguinal hernia repair. METHODS: This is a randomized controlled trial conducted at Jinnah Postgraduate Medical Centre, Karachi. A total of 186 patients of male gender between ages 20-60 years with incarcerated, obstructed and strangulated inguinal hernia were enrolled in the study...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#7
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29330194/telotristat-ethyl-in-carcinoid-syndrome-safety-and-efficacy-in-the-telecast-phase-3-trial
#8
Marianne E Pavel, David J Gross, Marta Benavent, Petros Perros, Raj Srirajaskanthan, Richard R P Warner, Matthew H Kulke, Lowell Anthony, Pamela Kunz, Dieter Hörsch, Martin O Weickert, Pablo Lapuerta, Wenjun Jiang, Kenneth Kassler-Taub, Suman Wason, Rosanna Fleming, Douglas Fleming, Rocio García-Carbonero
Telotristat ethyl, a tryptophan hydroxylase inhibitor, was efficacious and well tolerated in the Phase 3 TELESTAR study in patients with carcinoid syndrome (CS) experiencing ≥4 bowel movements per day (BMs/day) while on somatostatin analogs (SSAs). TELECAST, a Phase 3 companion study, assessed safety and efficacy of telotristat ethyl in patients with CS (diarrhea, flushing, abdominal pain, nausea, or elevated urinary 5-hydroxyindoleacetic acid [u5-HIAA]) with <4 BMs/day on SSAs (or ≥1 symptom or ≥4 BMs/day if not on SSAs) during a 12-week double-blind treatment period followed by a 36-week open-label extension (OLE)...
January 12, 2018: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29330071/onabotulinumtoxina-for-the-treatment-of-post-stroke-distal-lower-limb-spasticity-a-randomized-trial
#9
Theodore Wein, Alberto Esquenazi, Wolfgang H Jost, Anthony B Ward, Grace Pan, Rozalina Dimitrova
BACKGROUND: Post-stroke distal lower limb spasticity impairs mobility, limiting activities of daily living, requiring additional caregiver time. OBJECTIVE: To evaluate the efficacy, safety, and sustained benefit of onabotulinumtoxinA in adults with post-stroke lower limb spasticity (PSLLS). DESIGN: A multicenter, randomized, double-blind, phase 3, placebo-controlled trial. SETTING: 60 study centers across North America, Europe, Russia the United Kingdom, and South Korea...
January 9, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29329493/a-randomized-double-blind-controlled-trial-of-intravenous-meloxicam-in-the-treatment-of-pain-following-dental-impaction-surgery
#10
Steven E Christensen, Stephen A Cooper, Randall J Mack, Stewart W McCallum, Wei Du, Alex Freyer
This randomized, controlled phase 2 study was conducted to evaluate the analgesic efficacy, safety, and tolerability of single intravenous (IV) doses of 15 mg, 30 mg, and 60 mg meloxicam compared with oral ibuprofen 400 mg and placebo after dental impaction surgery. The primary efficacy end point was the sum of time-weighted pain intensity differences for 0-24 hours postdose. Among 230 evaluable subjects, meloxicam IV 60 mg produced the greatest reduction in pain, followed by the 30-mg and 15-mg doses. Statistically significant differences in summed pain intensity differences over 24 hours were demonstrated for each active-treatment group vs placebo (favoring active treatment) and for meloxicam IV 30 mg and 60 mg vs ibuprofen 400 mg (favoring meloxicam IV)...
January 12, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29328792/identification-and-management-of-nontraumatic-splenic-rupture
#11
Samanthi De Silva
A 43-year old previously fit and well gentleman presented to the emergency department (ED) with a two day history of worsening epigastric pain. He had had coryzal symptoms the preceding week but had no other past medical history. He was haemodynamically stable at presentation and an ultrasound scan (US) performed in the ED could not definitively rule out intra-abdominal fluid. In view of his tender abdomen on examination and a haemoglobin level of 9.2g/dL, a computerised tomography (CT) scan was performed and revealed extensive high-density fluid within the peritoneal cavity, raising the possibility of a concealed bleed but no obvious source was identified by the scan...
December 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328745/airway-safety-in-a-patient-with-submandibular-swelling
#12
Samanthi De Silva
A fifty-eight year old gentleman (CH) with a five-day history of toothache presented to the emergency department (ED) with increasing pain with associated submandibular swelling over the last 24-hours. He was an unkempt gentleman who had not consulted his general practitioner or dentist in many years, was unaware of any significant past medical history and was not on any regular medication. He was an obese gentleman with a BMI of 56.
March 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29327358/opioid-medication-use-in-patients-with-gastrointestinal-diagnoses-vs-unexplained-gastrointestinal-symptoms-in-the-us-veterans-health-administration
#13
G S Sayuk, N Kanuri, C P Gyawali, B M Gott, B D Nix, R A Rosenheck
BACKGROUND: While opioid prescriptions have increased alarmingly in the United States (US), their use for unexplained chronic gastrointestinal (GI) pain (eg, irritable bowel syndrome) carries an especially high risk for adverse effects and questionable benefit. AIM: To compare opioid use among US veterans with structural GI diagnoses (SGID) and those with unexplained GI symptoms or functional GI diagnoses (FGID), a group for whom opioids have no accepted role. METHODS: Veterans Health Administration (VHA) administrative data from fiscal year 2012 were used to identify veterans with diagnostic codes recorded for SGID and FGID...
January 12, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29327341/combined-thoracic-paravertebral-and-pectoral-nerve-blocks-for-breast-surgery-under-sedation-a-prospective-observational-case-series
#14
A Pawa, J Wight, D N Onwochei, R Vargulescu, I Reed, L Chrisman, E Pushpanathan, A Kothari, K El-Boghdadly
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29327128/isolated-avulsion-fracture-of-the-first-metatarsal-base-at-the-peroneus-longus-tendon-attachment-a-case-report
#15
Maxwell W Weinberg, Nicola Krähenbühl, Nathan P Davidson, Christopher J Hanrahan, Alexej Barg
Avulsion fractures of the first metatarsal (MT1) base at the peroneus longus (PL) tendon attachment are rare and may be undiagnosed during an emergency visit. If the injury is not treated properly, chronic pain or persistent impairment for inversion and plantar-flexion of the first ray may occur. This case report presents a 30-year-old woman who presented 10 weeks post trauma to a foot and ankle surgeon due to a swollen right midfoot with diffuse tenderness over the medial Lisfranc joint. Further evaluation showed an isolated avulsion fracture of the first metatarsal, which was undiagnosed during the emergent visit following the accident...
January 11, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29326821/age-sex-and-gene-expression-score-identifies-a-symptomatic-nondiabetic-male-patient-as-being-at-high-risk-of-obstructive-coronary-artery-disease
#16
Ronald J Polinsky
In October 2015, a 74-year-old Caucasian male patient (past medical history of hyperlipidemia, paroxysmal atrial fibrillation, hypertension, and hypothyroidism) presented to the cardiologist for follow-up outpatient evaluation of exertional chest pain. The patient had recently been seen at the Emergency Department for the same complaint. At that time, the patient's cardiac markers, EKG, and pharmacological nuclear stress testing were all reported as normal. At presentation to the cardiologist, the patient's physical examination findings were unremarkable...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29325441/five-year-experience-of-an-inpatient-palliative-care-unit-at-an-academic-referral-center
#17
Myrick C Shinall, Sara F Martin, Jill Nelson, Richard S Miller, Matthew W Semler, Eli E Zimmerman, Christy C Noblit, E Wesley Ely, Mohana Karlekar
BACKGROUND: Palliative care units (PCUs) staffed by specialty-trained physicians and nurses have been established in a number of medical centers. The purpose of this study is to review the 5-year experience of a PCU at a large, urban academic referral center. METHODS: We retrospectively reviewed a prospectively collected database of all admissions to the PCU at Vanderbilt University Medical Center in the first 5 years of its existence, from 2012 through 2017. RESULTS: Over these 5 years, there were 3321 admissions to the PCU...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29325179/comprehensive-profiles-of-psychological-and-social-work-factors-as-predictors-of-site-specific-and-multi-site-pain
#18
Jan Olav Christensen, Morten Birkeland Nielsen, Live Bakke Finne, Stein Knardahl
Objective Despite the multifactoriality of work and health, studies of psychosocial work factors with pain are typically limited to a few factors. This study examined a wide range of factors to determine (i) typical combinations of work factor levels ("work situations") and (ii) whether "work situations" predicted pain complaints of six anatomic regions. Methods Questionnaires were distributed to 6175 employees twice over a two-year period. Latent profile analysis was conducted to group employees into profiles of work factor levels...
January 11, 2018: Scandinavian Journal of Work, Environment & Health
https://www.readbyqxmd.com/read/29324936/the-impact-of-lung-perfusion-scintigraphy-in-the-emergency-management-of-patients-with-suspected-pulmonary-embolism
#19
Cristina Ferrari, Alessandra Cimino, Giacomo Bianco, Francesca Iuele, Alessandra Di Palo, Margherita Fanelli, Artor Niccoli-Asabella, Giuseppe Rubini
OBJECTIVE: Pulmonary Embolism (PE) is an emergency condition that requires immediate treatment. As the symptoms and the risk factors are nonspecific, PE differential diagnosis is often required. Even if angio-CT is considered the gold standard for PE diagnosis, the frequent allergic condition and/or chronic renal failure of patients make, in most cases, not possible the use of contrast enhancement in emergency with even more increasing use of Lung Perfusion Scintigraphy (LPS), as a simple and fast examination with no preparation/contraindication...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29324631/pediatric-appendicitis-association-of-chief-complaint-with-missed-appendicitis
#20
Zachary Drapkin, Jennifer Dunnick, Troy E Madsen, Matthew Bryce, Jeff E Schunk
OBJECTIVES: We evaluated the association between the emergency department (ED) triage chief complaint and rate of missed appendicitis in children. METHODS: We performed a retrospective chart review of patients who presented to a pediatric ED and were diagnosed with appendicitis over 5 years (July 1, 2009 to June 30, 2014). We reviewed the medical record for any additional ED visits in the 7 days preceding the diagnosis of appendicitis. Triage chief complaints were classified as "suggestive of appendicitis" (abdominal pain, right lower quadrant pain, or rule out appendicitis) or "nonspecific" (fever, vomiting, dehydration, etc)...
January 11, 2018: Pediatric Emergency Care
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