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Pain and emergency

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https://www.readbyqxmd.com/read/28931203/scalpel-versus-electrosurgery-for-major-abdominal-incisions
#1
REVIEW
Kittipat Charoenkwan, Zipporah Iheozor-Ejiofor, Kittipan Rerkasem, Elizabeth Matovinovic
BACKGROUND: Scalpels or electrosurgery can be used to make abdominal incisions. The potential benefits of electrosurgery may include reduced blood loss, dry and rapid separation of tissue, and reduced risk of cutting injury to surgeons. Postsurgery risks possibly associated with electrosurgery may include poor wound healing and complications such as surgical site infection. OBJECTIVES: To assess the effects of electrosurgery compared with scalpel for major abdominal incisions...
June 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28930004/enteric-infections-circulating-during-hajj-seasons-2011-2013
#2
Moataz Abd El Ghany, Mona Alsomali, Malak Almasri, Eriko Padron Regalado, Raeece Naeem, AbdulHafeez Tukestani, Abdullah Asiri, Grant A Hill-Cawthorne, Arnab Pain, Ziad A Memish
Hajj, the annual Muslim pilgrimage to Mecca, Saudi Arabia, is a unique mass gathering event that raises public health concerns in the host country and globally. Although gastroenteritis and diarrhea are common among Hajj pilgrims, the microbial etiologies of these infections are unknown. We collected 544 fecal samples from pilgrims with medically attended diarrheal illness from 40 countries during the 2011-2013 Hajj seasons and screened the samples for 16 pathogens commonly associated with diarrheal infections...
October 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28929914/the-conundrum-of-opioid-tapering-in-long-term-opioid-therapy-for-chronic-pain-a-commentary
#3
Ajay Manhapra, Albert A Arias, Jane C Ballantyne
BACKGROUND: In response to the opioid epidemic and new guidelines, many patients on high-dose long term opioid therapy (LTOT) for chronic pain are getting tapered off opioids. As a result, a unique clinical challenge is emerging: while many on LTOT have poor pain control, functional decline, psychiatric instability, aberrancies and misuse, these issues may often worsen with opioid tapering. Currently, a clear explanation and practical guidance on how to manage this perplexing clinical scenario is lacking...
September 20, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28929260/preferences-for-injectable-prep-among-young-u-s-cisgender-men-and-transgender-women-and-men-who-have-sex-with-men
#4
Katie B Biello, Sybil Hosek, Morgan T Drucker, Marvin Belzer, Matthew J Mimiaga, Elliot Marrow, Julia Coffey-Esquivel, Jennifer Brothers, Kenneth H Mayer
Young men who have sex with men account for approximately 20% of incident HIV infections in the U.S. Antiretroviral pre-exposure prophylaxis (PrEP) administered as a daily pill has been shown to decrease HIV acquisition in at-risk individuals. New modalities for PrEP are being developed and tested, including injectable PrEP; however, acceptability of these emerging modalities has not yet been examined in youth. We conducted six focus groups with 36 young men and transgender men and women who have sex with men in Boston, Chicago, and Los Angeles in 2016 to assess interest in and preference for different PrEP modalities...
September 19, 2017: Archives of Sexual Behavior
https://www.readbyqxmd.com/read/28929043/supraventricular-tachycardia-and-tricuspid-regurgitation-in-the-setting-of-misplaced-implantable-port-catheter-tip
#5
Ahmad Awan, Bisma Ahsan, Hasan Iftikhar, Akbar Khan, Fasil Tiruneh, Yididia Bekele, Ankit Mahajan, Ahmed A Awan
We present the case of a 31-year-old female with a past medical history of B-cell leukemia, on maintenance chemotherapy administered via centrally placed implantable catheter port, who presented to the emergency room with fever, chills, and generalized body pain of one day's duration. After initial workup, the patient was admitted to the intensive care unit and managed for severe sepsis. The patient was found to have a new-onset 3/6 holosystolic murmur at the left lower sternal border. Furthermore, she developed an episode of supraventricular tachycardia that responded to adenosine...
July 11, 2017: Curēus
https://www.readbyqxmd.com/read/28929031/procalcitonin-a-powerful-rescuer-on-surgical-floors
#6
EDITORIAL
Ahsan Zil-E-Ali, Syeda Naqvi, Mariam Tariq
Necrotizing fasciitis (NF) is a rare but life-threatening medical and surgical emergency. It is characterized by necrosis of the soft tissue leaving the overlying tissue unaffected, which delays the diagnosis and treatment. Delay in recognition of the severity of necrotizing fasciitis might lead to serious morbidity and mortality. Diagnosis of NF relies on strong clinical judgment, predictable by severe pain, erythema, and a presence of air under the skin, but all of them are not always present. Management of NF is prompt surgical intervention and antimicrobial therapy...
July 8, 2017: Curēus
https://www.readbyqxmd.com/read/28928927/unusual-cause-of-acute-scrotum-in-children-a-case-report
#7
Salahoudine Idrissa, Mohamed Amine Oukhouya, Mohamed Tazi, Abdelhalim Mahmoudi, Aziz Elmadi, Khalid Khattala, Youssef Bouabdallah
A 13-year-old boy was presented in the pediatric emergency with a 2-week history of swelling of the right scrotal contents of simple evolution, which was worsened by the appearance of an acute scrotal pain 48 h prior to his consultation. The doppler ultrasound and computed tomography (CT) scan revealed an incarceration of the omentum in an inguinal hernia. Acute scrotal pain and swelling is a common reason for surgical consultation in the emergency department of children. However, omentum is a rare content of inguinal hernia in children and infarct is exceptional...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28928589/laparoscopic-cholecystectomy-under-segmental-thoracic-spinal-anesthesia-a-feasible-economical-alternative
#8
Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal
Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml(-1) mixed with 0.5 ml of fentanyl 50 μg ml(-1). Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928493/associations-between-low-back-pain-and-depression-and-somatization-in-a-canadian-emerging-adult-population
#9
David Robertson, Dinesh Kumbhare, Paul Nolet, John Srbely, Genevieve Newton
INTRODUCTION: The association between depression, somatization and low back pain has been minimally investigated in a Canadian emerging adult population. METHODS: 1013 first year Canadian university students completed the Modified Zung Depression Index, the Modified Somatic Perception Questionnaire, and a survey about low back pain frequency and intensity. Multinomial logistic regression was used to measure associations between low back pain and depression and somatization, both independently and co-occurring...
August 2017: Journal of the Canadian Chiropractic Association
https://www.readbyqxmd.com/read/28928325/transversus-abdominis-plane-block-for-pain-relief-in-patients-undergoing-in-endoscopic-repair-of-abdominal-wall-hernia-a-comparative-randomised-double-blind-prospective-study
#10
Aparna Sinha, Lakshmi Jayaraman, Dinesh Punhani, Pradeep Chowbey
INTRODUCTION: Transversus abdominis plane (TAP) block is now a well-established technique in post-operative analgesia for lower abdominal surgeries. We evaluated the effect of ultrasound-guided TAP block on recovery parameters in patients undergoing endoscopic repair of abdominal wall hernia. METHODS: Thirty adults were randomised to receive either ropivacaine with dexmedetomidine (TR) or saline (TP) in TAP block, before emergence from anaesthesia. The patients were assessed for pain relief, sedation, time to ambulate (TA), discharge readiness (DR), postoperative opioid requirement and any adverse events...
September 20, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28927649/coping-with-pain-in-intimate-situations-applying-the-avoidance-endurance-model-to-women-with-vulvovaginal-pain
#11
I K Flink, L Engman, M M Ter Kuile, J Thomtén, S J Linton
BACKGROUND AND AIMS: Chronic vulvovaginal pain is strikingly common and has a serious impact on women's lives. Nevertheless, there are few longitudinal studies focusing on mechanisms involved in the pain development. One area of interest is how women cope with sexual activities and how this affects their pain. In this study, avoidance and endurance coping behaviors were explored as possible mediators of the relation between catastrophizing and pain, cross-sectionally and longitudinally...
September 15, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28927228/management-of-chronic-pain-through-pain-management-programmes
#12
I R Wilson
Introduction: Chronic pain carries significant impact and is difficult to treat with limited success. Pain management programmes (PMPs) use cognitive behavioural therapy (CBT)-based multidisciplinary rehabilitative approaches to drive functional improvement. Sources of data: A search was conducted using Medline and the Cochrane Library to identify published literature about PMPs or CBT to treat chronic pain. Areas of agreement: PMPs have significant benefit on functioning for some patients but relatively little impact on the pain...
September 13, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28926506/family-perspectives-on-visiting-the-pediatric-emergency-department-for-migraine-a-qualitative-study
#13
Serena Laura Orr, Liam OʼSullivan, Roger Zemek, Natalie M Ward, Hugh J McMillan
OBJECTIVE: The aim of this study was to explore the perspectives of families regarding their expectations and experience of visiting the emergency department (ED) for migraine. METHODS: This was a qualitative study involving the families of 25 patients aged 10 to 18 years receiving ED care for acute migraine. Following their visit, independent semistructured telephone interviews were conducted with both the patient and parent or guardian. Questions were designed to explore factors pertaining to the family's perspective regarding their visit to the ED and expectations for the ED visit...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28926470/acceptability-and-practicality-of-the-turkish-translation-of-pediatric-gait-arm-legs-and-spine-in-turkish-children
#14
Ezgi Deniz Batu, Özge Keniş Coşkun, Hafize Emine Sönmez, Duygu Karali, Elif Arslanoğlu Aydin, Yelda Bilginer, Evrim Karadağ Saygi, Seza Özen
BACKGROUND: The pediatric Gait, Arms, Leg, and Spine (pGALS) is a practical questionnaire for musculoskeletal (MSK) system evaluation in school-age children. OBJECTIVE: The aim of this study was to evaluate the acceptability/practicality of pGALS Turkish translation in Turkey (cross-sectional study). METHODS: The Turkish translation of pGALS was administered to children (4-18 years) who attended to the Pediatric Emergency Department of Hacettepe University, Ankara, Turkey, and the outpatient clinic of the Physical Therapy and Rehabilitation Department of Marmara University, Istanbul, Turkey, during 1 month in 2016...
September 19, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#15
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28925661/no-added-benefit-with-higher-doses-of-ketorolac-for-treatment-of-acute-pain-in-the-emergency-department
#16
Nita Shrikant Kulkarni
No abstract text is available yet for this article.
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#17
Brian V Reamy, Pamela M Williams, Michael Ryan Odom
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28924614/porcelain-gallbladder-often-an-overlooked-entity
#18
Sohail Iqbal, Sarfraz Ahmad, Usman Saeed, Mohammed Al-Dabbagh
Background  Porcelain gallbladder (GB) is a rare but potentially premalignant condition with minimal symptoms. Accident and Emergency (A&E) departments often tend to investigate abdominal pain through plain radiographs, which are occasionally reported by radiologists, thereby leaving behind few uncommon conditions, such as porcelain gallbladder unreported. Objectives  We present three cases of porcelain GB in which initial diagnosis was not considered due to the presence of various other calcifications in the upper abdomen...
October 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28924518/clinical-spectrum-of-chikungunya-in-pakistan
#19
Syeda Naqvi, Shehroz Bashir, Chintan Rupareliya, Abdullah Shams, Pirthvi Raj Giyanwani, Zeeshan Ali, Faiza Qamar, Vijesh Kumar, Vikash Talib
Background Chikungunya fever is a pandemic disease caused by an arthropod-borne chikungunya virus (CHIKV). The virus spreads through mosquitoes. This mosquito induced viral illness is clinically suspected on symptoms from fever and severe polyarthralgia. The recent outbreak of chikungunya was reported in November 2016 in the metropolitan city Karachi, Pakistan. We emphasis on the awareness of the etiology and vector control to prevent serious consequences. Method A total number of 1275 patients were included in this cross-sectional study...
July 6, 2017: Curēus
https://www.readbyqxmd.com/read/28924279/value-of-leucine-rich-alpha-2-glycoprotein-1-lrg-1-on-diagnosis-of-acute-appendicitis-in-female-patients-with-right-lower-quadrant-abdominal-pain
#20
Osman Lutfi Demirci, Yunsur Cevik, Seref Kerem Corbacioglu, Alpaslan Taner
OBJECTIVE: To assess the diagnostic usefulness of leucine-rich alpha-2-glycoprotein-1 in female patients with acute abdominal pain on right lower-quadrant and acute appendicitis. METHODS: The prospective, cross-sectional study was conducted at the emergency department of Kecioren Training and Research Hospital, Ankara, Turkey, during a two-month period in 2014, and comprised patients with acute abdominal pain in right lower-quadrant, and control subjects. Female patients aged 18-60 years who were admitted to the hospital's emergency department were included...
September 2017: JPMA. the Journal of the Pakistan Medical Association
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