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Pain and emergency

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https://www.readbyqxmd.com/read/28346771/cohort-study-of-oncologic-emergencies-in-patients-with-head-and-neck-cancer
#1
Cielito C Reyes-Gibby, Stephanie C Melkonian, Ehab Y Hanna, Sai-Ching J Yeung, Charles Lu, Mark S Chambers, Srinivas R Banala, Gary B Gunn, Sanjay S Shete
BACKGROUND: Treatments for head and neck squamous cell carcinoma (HNSCC) are associated with toxicities that lead to emergency department presentation. METHODS: We utilized data from an ongoing prospective cohort of newly diagnosed, previously untreated patients (N = 298) with HNSCC to evaluate the association between clinical and epidemiologic factors and risk for and frequency of emergency department presentation. Time to event was calculated from the date of treatment initiation to emergency department presentation, date of death, or current date...
March 27, 2017: Head & Neck
https://www.readbyqxmd.com/read/28346243/modeling-flowsheet-data-to-support-secondary-use
#2
Bonnie L Westra, Beverly Christie, Steven G Johnson, Lisiane Pruinelli, Anne LaFlamme, Suzan G Sherman, Jung In Park, Connie W Delaney, Grace Gao, Stuart Speedie
The purpose of this study was to create information models from flowsheet data using a data-driven consensus-based method. Electronic health records contain a large volume of data about patient assessments and interventions captured in flowsheets that measure the same "thing," but the names of these observations often differ, according to who performs documentation or the location of the service (eg, pulse rate in an intensive care, the emergency department, or a surgical unit documented by a nurse or therapist or captured by automated monitoring)...
March 24, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28345443/economic-burden-of-irritable-bowel-syndrome-with-diarrhea-retrospective-analysis-of-a-u-s-commercially-insured-population
#3
Jessica L Buono, Kush Mathur, Amelia J Averitt, David A Andrae
BACKGROUND: The economic burden associated with irritable bowel syndrome with diarrhea (IBS-D) is not well understood. OBJECTIVES: To (a) evaluate total annual all-cause, gastrointestinal (GI)-related, and symptom-related (i.e., IBS, diarrhea, abdominal pain) health care resource use and costs among IBS-D patients in a U.S. commercially insured population and (b) estimate incremental all-cause health care costs of IBS-D patients versus matched controls. METHODS: Patients aged ≥ 18 years with 12 months of continuous medical and pharmacy benefit eligibility in 2013 were identified from the Truven Health MarketScan research database...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345065/diabetic-ketoacidosis-as-the-presenting-manifestation-of-pancreatic-adenocarcinoma-with-cystic-features
#4
Tezcan Kaya, Sumeyye Korkmaz, Erdem Vargol, Alper Karacan, Hakan Cinemre
The common presenting symptoms of pancreatic cancer are abdominal pain, weight loss, and jaundice. Pancreatic adenocarcinoma presenting with diabetic ketoacidosis is a very rare emergent clinical condition. However, pancreatic ductal cystadenocarcinoma presenting with diabetic ketoacidosis was not reported. We describe a 60-year-old man with pancreatic cystadenocarcinoma presenting with diabetic ketoacidosis as the initial manifestation. It must be kept in mind that in diabetic ketoacidosis cases, the precipitating factor may be pancreatic ductal cystadenocarcinoma...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28344951/a-case-of-littr%C3%A3-s-hernia-at-zinder-national-hospital-zinder-niger
#5
I Amadou Magagi, H Adamou, O Habou
The presence of a Meckel's diverticulum in a hernia sac is known as Littré's hernia. We report a case of Littré's hernia in an 18-year old young man because of the uncommon condition. An 18-year old young patient was admitted to the Emergency Surgical Department of Zinder National Hospital, Zinder, Niger with a painful inguinoscrotal swelling of three days duration. The diagnosis of strangulated right inguinoscrotal hernia was made. At surgery, a Meckel's diverticulum was found at the antimesenteric border of the ileum in the hernia sac, the bowel loop was not viable...
April 2016: Journal of the West African College of Surgeons
https://www.readbyqxmd.com/read/28343650/-surveillance-system-on-drug-abuse-interest-of-the-french-national-oppidum-program-of-french-addictovigilance-network
#6
Elisabeth Frauger, Liselotte Pochard, Quentin Boucherie, Adeline Giocanti, Cécile Chevallier, Amélie Daveluy, Valérie Gibaja, Anne-Sylvie Caous, Céline Eiden, Nicolas Authier, Reynald Le Boisselier, Marylène Guerlais, Émilie Jouanjus, Marion Lepelley, Véronique Pizzoglio, Stéphanie Pain, Nathalie Richard, Joëlle Micallef
It is important to assess drug abuse liability in 'real life' using different surveillance systems. OPPIDUM ('Observation of illegal drugs and misuse of psychotropic medications') surveillance system anonymously collects information on drug abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. The aim of this article is to demonstrate the utility of OPPIDUM system using 2015 data. OPPIDUM is a cross-sectional survey repeated each year since 1995. In 2015, 5003 patients described the modality of use of 10,159 psychoactive drugs...
February 22, 2017: Thérapie
https://www.readbyqxmd.com/read/28343155/more-than-just-muscle-spasms-a-rare-presentation-of-aortic-dissection
#7
Ebisa Bekele, Deepthi Chaitanya Kagolanu, Martin Kim, Kent Stephenson
Acute aortic dissection is associated with significant morbidity and mortality, often from complications including aortic regurgitation, cardiac tamponade and myocardial infarction. Typical clinical presentation includes a sudden onset of severe chest pain, although this is not always consistent. Clinical signs and symptoms are diverse with an estimated 38% of cases being missed on initial evaluation. Primary neurological symptoms at presentation are rare but have been reported often to coexist with chest pain...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28343154/silent-uterine-rupture-in-scarred-uterus
#8
Ream Langhe, Umme Farwa Shah, Attia Alfathil, Michael Gannon
Uterine rupture in pregnancy is a rare and catastrophic complication with a high incidence of fetal and maternal morbidity. Very few cases have been reported in the literature. CASE PRESENTATION: A 28-year-old fifth gravid woman with a history of one caesarean section presented to our department at 39 weeks and 6 days gestation with complaints of headache, epigastric pain and nausea. Her blood pressure was elevated and there was proteinuria. Emergency caesarean section was performed in view of symptoms...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28343153/de-garengeot-s-hernia-an-unusual-case-on-call
#9
Madeline Moore, Bassem Amr
De Garengeot's hernia is defined as a femoral hernia that contains the appendix. Owing to the extreme rarity of de Garengeot's hernia, it could represent a diagnostic challenge; however, it should remain in the differential diagnosis, particularly in this patient demographic. A female patient aged 96 years, who presented as an emergency with acute right iliac fossa pain, was found to have de Garengeot's hernia. The diagnosis was made intraoperatively, where she was treated with an appendicectomy and repair of the hernia defect...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28343112/the-impact-of-australian-legislative-changes-on-synthetic-cannabinoid-exposures-reported-to-the-new-south-wales-poisons-information-centre
#10
Rose Cairns, Jared A Brown, Naren Gunja, Nicholas A Buckley
BACKGROUND: The emergence of new psychoactive substances (NPS), including synthetic cannabinoid receptor agonists (SCRAs) poses novel challenges for drug regulation and public health. Misconceptions of safety and legality, coupled with the fact that NPS are undetectable on routine drugs screens contributes to their popularity. Concerns over the unpredictable toxicity and abuse potential of NPS has led to a variety of legislative responses worldwide. We wish to describe Australian trends in SCRA use, examining the effects of legislative changes on calls to Australia's largest poisons centre...
March 23, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28342663/intramural-coronary-hematoma-a-complex-three-dimensional-entity-multimodality-assessment
#11
Iván J Núñez-Gil, Mauro Echavarría-Pinto, Gisela Feltes, Antonio Fernández-Ortiz
A 62-year-old woman was admitted with chest pain of two hours' duration, ECG changes in the precordial leads and left ventricular ejection fraction of 30% on the echocardiogram. Emergent catheterization demonstrated severe flow disturbance in the left coronary artery. An intra-aortic balloon pump and a drug-eluting stent were implanted. However, the flow disturbance persisted. Optical coherence tomography followed by intravascular ultrasound provided crucial data on the mechanism and helped to optimize treatment in this critical patient...
March 22, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28342574/ultrasound-findings-in-tension-pneumothorax-a-case-report
#12
Maxine Inocencio, Jeannine Childs, Mikaela L Chilstrom, Kristin Berona
BACKGROUND: Delayed recognition of tension pneumothorax can lead to a mortality of 31% to 91%. However, the classic physical examination findings of tracheal deviation and distended neck veins are poorly sensitive in the diagnosis of tension pneumothorax. Point-of-care ultrasound is accurate in identifying the presence of pneumothorax, but sonographic findings of tension pneumothorax are less well described. CASE REPORT: We report the case of a 21-year-old man with sudden-onset left-sided chest pain...
March 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28342209/from-somatic-pain-to-psychic-pain-the-body-in-the-psychoanalytic-field
#13
Thomas Hartung, Michael Steinbrecher
The integration of psyche and soma begins with a baby's earliest contact with his or her parents. With the help of maternal empathy and reverie, β-elements are transformed into α-elements. While we understand this to be the case, we would like to enquire what actually happens to those parts of the affect which have not been transformed? For the most part they may be dealt with by evacuation, but they can also remain within the body, subsequently contributing to psychosomatic symptoms. This paper describes how the body serves as an intermediate store between the psychic (inner) and outer reality...
March 24, 2017: International Journal of Psycho-analysis
https://www.readbyqxmd.com/read/28341682/the-royal-college-of-emergency-medicine-composite-pain-scale-for-children-level-of-inter-rater-agreement
#14
Ffion James, Rosie Edwards, Nirmal James, Rhian Dyer, Victoria Goodwin
OBJECTIVE: To assess the inter-rater agreement of the Royal College of Emergency Medicine (RCEM) Composite Pain Scale. METHODS: A prospective, observational study of 117 children who presented to the ED with pain due to a limb injury. Pain severity was assessed by the triage nurse, doctor and child (depending on their age) using indicators of the RCEM Composite Pain Scale. This pain scale comprises a modified Wong-Baker FACES Pain Rating Scale (FACES Scale), a Behaviour scale and a numerical rating scale (Ladder)...
March 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28341442/risk-factors-for-postoperative-delirium-after-colorectal-operation
#15
Frederik J van der Sluis, Pieter L Buisman, Mark Meerdink, Wouter B Aan de Stegge, Boudewijn van Etten, Geertruida H de Bock, Barbara L van Leeuwen, Robert A Pol
BACKGROUND: A clear understanding of risk factors for postoperative delirium helps in the selection of individuals who might benefit from targeted perioperative intervention. The aim of this study was to identify risk factors for postoperative delirium after colorectal operation for malignancy. METHODS: All consecutive patients who underwent elective or emergency operation because of malignancy of the colon, sigmoid, or rectum between 2009 and 2012 were included in this study...
March 2017: Surgery
https://www.readbyqxmd.com/read/28341306/high-frequency-qrs-analysis-in-the-evaluation-of-chest-pain-in-the-emergency-department
#16
Ori Galante, Guy Amit, Yair Granot, Linda R Davrath, Shimon Abboud, Doron Zahger
OBJECTIVES: High frequency QRS (HFQRS) analysis has been shown to be an accurate marker for myocardial ischemia. Our objective was to test the use of HFQRS in diagnosing ACS in the emergency department. METHODS: 324 patients presenting to the ED with chest pain were enrolled. Resting ECG was recorded and later analyzed by an HFQRS algorithm. Results were compared to the conventional ECG diagnosis by 3 independent interpretations: treating physician, expert cardiologist and an automated computer program...
February 20, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28341086/recurrent-priapism-gone-wrong-st-elevation-myocardial-infarction-and-cardiogenic-shock-after-penile-corporal-phenylephrine-irrigation
#17
S Tyler Constantine, Anand Gopalsami, Gregg Helland
BACKGROUND: Recurrent priapism secondary to sickle cell trait in an African-American male has been reported in the literature. A common treatment for these low-flow priapism cases is aspiration and injection of the corpus cavernosum with a sympathomimetic agent. We report a rare complication not described previously in the literature of ST-elevation myocardial infarction (STEMI) and cardiogenic shock in a 29-year-old male with sickle cell trait undergoing a routine detumescence procedure...
March 21, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28340041/bleeding-complications-in-patients-undergoing-intrathecal-drug-delivery-system-implantation
#18
Nafisseh S Warner, Markus A Bendel, Matthew A Warner, Jacob J Strand, Halena M Gazelka, Bryan C Hoelzer, William D Mauck, Tim J Lamer, Daryl J Kor, Susan M Moeschler
Introduction.:  Intrathecal drug delivery systems (IDDSs) have dramatically improved analgesia and the functional status of cancer patients and those with chronic pain states. However, given the close proximity to the neuraxis and frequent concomitant use of antiplatelet or anticoagulant medications, this intervention is not without risk. The goal of this investigation was to determine the incidence of bleeding complications following IDDS placement. Methods.:  This is a retrospective review from 2005 through 2014 of adult patients undergoing IDDS implantation or revision at a tertiary care center...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339989/pain-management-strategies-and-health-care-use-in-community-dwelling-individuals-living-with-chronic-pain
#19
Elizabeth G Mann, Ana Johnson, Ian Gilron, Elizabeth G VanDenKerkhof
Objective. : To describe factors associated with high clinic and emergency room (ER) use among individuals with chronic pain. Design. : This study is part of a larger cross-sectional survey on the epidemiology of chronic pain in Canada. The current analysis was guided by the Andersen-Newman Service Utilization Model. Methods. : Respondents (N = 702) were grouped into high (top 10%) and low (bottom 90%) users based on the number of visits made to clinics and ERs over the past year...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339988/utilization-of-health-care-services-and-ambulatory-resources-associated-with-chronic-noncancer-pain
#20
Cynthia Kay, Erica Wozniak, Joanne Bernstein
Objective.:  Examine traditional and uncompensated health care utilization associated with chronic noncancer pain. Design.:  Retrospective chart review. Setting.:  Tertiary academic medical center. Subjects.:  Internal medicine patients on long-term opioids for chronic noncancer pain with or without a pain agreement between April 1, 2014, and April 1, 2015 (N = 834). Patients without pain served as controls (N = 782)...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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