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https://www.readbyqxmd.com/read/29216664/-acute-scrotal-pain-in-childhood-legal-pitfalls
#1
Pia Bader, Christoph Hugemann, Detlef Frohneberg
Acute scrotal pain in childhood is an emergency.Sudden scrotal pain may be caused by a variety of diseases. Therefore, it is important to carefully consider the specific medical history and possible differential diagnoses in each case for fast and decisive action (e. g. in case of testicular torsion). As minors lack the capacity for consent, it is absolutely necessary to obtain consent from their legal guardian. However, obtaining consent in the available time frame can cause organisational challenges in an acute emergency, which may lead to situations in the daily routine where a therapeutic decision needs to be taken (including surgery) without legal security based on consent by the guardian...
December 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/29209790/-delegation-of-medical-activities-in-acute-pain-therapy
#2
REVIEW
J Erlenwein, A Moroder, E Biermann, F Petzke, A P F Ehlers, H Bitter, E Pogatzki-Zahn
Acute pain management is an interprofessional and interdisciplinary task and requires a good and trustful cooperation between stakeholders. Despite provisions in Germany according to which medical treatment can only be rendered by a formally qualified physician ("Arztvorbehalt"), a physician does not have to carry out every medical activity in person. Under certain conditions, some medical activities can be delegated to medical auxiliary personnel but they need to be (1) instructed, (2) supervised and (3) checked by the physician himself; however, medical history, diagnostic assessment and evaluation, indications, therapy planning (e...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29201926/factors-associated-with-physician-loss-in-anterior-cruciate-ligament-reconstruction-malpractice-lawsuits
#3
Steven L Bokshan, Roy Ruttiman, Adam E M Eltorai, J Mason DePasse, Alan H Daniels, Brett D Owens
Background: Anterior cruciate ligament (ACL) reconstruction is among the most common orthopaedic procedures, with its incidence doubling over the past decade. To date, no studies have analyzed litigation after ACL reconstruction. Purpose: To characterize the causes of malpractice litigation after ACL reconstruction. Study Design: Cross-sectional study. Methods: A retrospective review of malpractice lawsuits after ACL reconstruction was performed using VerdictSearch, a large legal claims database encompassing nearly 180,000 legal cases, from February 1988 to May 2015...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29178487/therapeutic-benefit-of-smoked-cannabis-in-randomized-placebo-controlled-studies
#4
Lynneice L Bowen, Aimee L McRae-Clark
The medicinal use of marijuana has been legalized in 28 states, with a wide range of specificity for approved medical conditions. Even with the emergence of non-combustion-based delivery systems, in 2014, 90% of marijuana users used smoked marijuana. The purpose of this review is to summarize the data available on use of smoked marijuana for medical purposes. A literature search was performed to retrieve randomized controlled trials exploring the efficacy of smoked cannabis for treatment of a medical condition...
November 27, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29121790/knowledge-skills-and-attitudes-regarding-the-use-of-medical-cannabis-in-the-hospice-population-an-educational-intervention
#5
Kelly S Mendoza, Mary Lynn McPherson
BACKGROUND: Currently, 28 states and the District of Columbia have legalized cannabis for medical use despite its remaining Schedule I federally. Benefits of medical cannabis (MC) have been demonstrated in nausea/vomiting associated with chemotherapy, cachexia associated with HIV/AIDS, and certain types of neuropathic pain. However, it is unclear how comfortable hospice providers are with the concept of MC. OBJECTIVE: The aim of this study is to determine changes in knowledge, self-perceived skills, and attitudes (KSA) of hospice providers regarding MC after an online educational intervention...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29117023/legal-evidence-of-subjective-states-a-brain-based-model-of-chronic-pain-increases-accuracy-and-fairness-in-law
#6
Amanda C Pustilnik
Advances in structural and functional neuroimaging offer new ways to conceptualize chronic pain disorders and to prevent, diagnose, and treat chronic pain. Advances in pain science, though, do not entail changes in the concepts of chronic pain in law and culture. Authoritative legal and cultural conceptions of chronic pain continue to promote abstruse theories, characterizing these disorders as arising out of everything from a person's unmet need for love to resistance to "patriarchy." These constructs have consequences, impeding treatment and affecting whether individuals with chronic pain can obtain legal redress...
November 2017: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29109890/gossypiboma-resection-after-eight-years-in-a-patient-with-rheumatoid-arthritis-and-diabetes
#7
Kenley Unruh, Hsien Sing Sam Hsieh
Gossypiboma is the term used to refer to a mass formed by surgical material left in the body cavity after surgery. We present the case of a middle-aged woman with a history of rheumatoid arthritis controlled with corticosteroids and biologic therapies, uncontrolled type II diabetes mellitus, and cesarean section with postoperative bleeding eight years earlier, who presents with right lower quadrant abdominal pain and is found to have a gossypiboma from her previous operation. A subsequent operation is undertaken to remove the gossypiboma...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29107306/pharmacologic-interventions-for-pain-management
#8
REVIEW
Francisca Cisneros Farrar, Danielle White, Linda Darnell
Serious life-threatening respiratory depression may occur with pharmacologic pain intervention. The nurse has an ethical and legal duty to provide safe, quality, and accountable pain management. The nurse must acquire self-efficacy for the administration of pain medications for critically ill patients to prevent serious side effects and adverse reactions. This article presents a clinical toolkit for acute pain pharmacologic management by presenting professional guidelines, evidence-based pain assessment tools, common pain medication therapy, and focused monitoring specific to the drug...
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29107303/physiology-of-pain
#9
REVIEW
Deborah L Ellison
Acutely ill patients are challenging to frontline nurses because they frequently also have multiple chronic conditions. This article empowers all nurses to develop a foundational understanding of the physiology of acute and chronic pain. The skills, knowledge, and attitude to care for patients experiencing pain are a legal and ethical responsibility of all nurses. This article discusses the physiology of pain to include the neuronal receptors that respond to various painful stimuli, substances that stimulate nociceptors, the nerve pathways, modulation of the perception of pain, and acute verses chronic physiologic changes...
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29077662/kratom-an-emerging-drug-of-abuse-a-case-report-of-overdose-and-management-of-withdrawal
#10
Jack Diep, David Tian Chin, Somdatta Gupta, Faraz Syed, Ming Xiong, Jianguo Cheng
Kratom is an herb indigenous to Southeast Asia with psychoactive opioid compounds, often used as a treatment for chronic pain or opiate withdrawal symptoms. It is legally and readily available via Internet sales and has been identified as an emerging drug of abuse in the United States. Kratom use has been associated with psychosis, seizures, and even death. At lower doses, kratom acts as a stimulant, while at higher doses, it produces analgesia and euphoria. Here, we describe the successful management of kratom overdose and withdrawal in a young man with negative toxicology screens...
October 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29072481/classification-accuracy-of-the-minnesota-multiphasic-personality-inventory-2-mmpi-2-restructured-form-validity-scales-in-detecting-malingered-pain-related-disability
#11
Kevin J Bianchini, Luis E Aguerrevere, Kelly L Curtis, Tresa M Roebuck-Spencer, F Charles Frey, Kevin W Greve, Matthew Calamia
The symptom reports of individuals with chronic pain are multidimensional (e.g., emotional, cognitive, and somatic) and significantly contribute to increased morbidity and lost work productivity. When pain occurs in the context of a legally compensable event, reliable assessment of a patient's multifactorial symptom experience during psychological or neuropsychological evaluations is a necessity. The Validity Scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) have been shown useful in identifying symptom overreporting and feigning within chronic pain samples and a number of studies have emerged supporting the use of the MMPI-2-Restructured Form (MMPI-2-RF) in the detection of simulated or feigned impairment in a variety of populations...
October 26, 2017: Psychological Assessment
https://www.readbyqxmd.com/read/29067992/medical-cannabis-for-the-treatment-of-chronic-pain-and-other-disorders-misconceptions-and-facts
#12
Kevin P Hill, Matthew D Palastro
Recently, many countries have enacted new cannabis policies, including decriminalization of cannabis possession as well as legalization of medical and recreational cannabis. In this context, patients and their physicians have had an increasing number of conversations about the risks and benefits of cannabis. While cannabis and cannabinoids continue to be evaluated as pharmacotherapy for medical conditions, the best evidence currently exists for the following medical conditions: chronic pain, neuropathic pain, and spasticity resulting from multiple sclerosis...
November 30, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29062461/an-analysis-of-malpractice-litigation-and-expert-witnesses-in-plastic-surgery
#13
Paul J Therattil, Stella Chung, Aditya Sood, Mark S Granick, Edward S Lee
Objective: Expert witness testimony is crucial for juror decision making. The goals of this study were to examine the trends in malpractice litigation in plastic surgery and to examine the characteristics of expert witnesses in litigation. Methods: The Westlaw legal database was queried for jury verdict and settlement reports related to plastic surgery cases from 2009 to 2015. Cases were examined for expert witness testimony, procedure performed, alleged injury, cause of action, verdict, and indemnity payments...
2017: Eplasty
https://www.readbyqxmd.com/read/29061872/medical-cannabinoids-in-children-and-adolescents-a-systematic-review
#14
REVIEW
Shane Shucheng Wong, Timothy E Wilens
CONTEXT: Legalization of medical marijuana in many states has led to a widening gap between the accessibility and the evidence for cannabinoids as a medical treatment. OBJECTIVE: To systematically review published reports to identify the evidence base of cannabinoids as a medical treatment in children and adolescents. DATA SOURCES: Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of PubMed, Medline, and the Cumulative Index to Nursing and Allied Health Literature databases was conducted in May 2017...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29056081/the-risks-and-benefits-of-cannabis-in-the-dermatology-clinic
#15
Gurbir Dhadwal, Mark G Kirchhof
Cannabis ( Cannabis sativa/indica), also known as marijuana, has been used for medicinal and recreational purposes for millennia. There has been a recent trend to legalize the use of cannabis, as illustrated by the recent legalization votes in numerous states in the United States and legislation in Canada to allow recreational cannabis use. With this increasing consumption of cannabis, dermatologists will see increased pressure to prescribe cannabis and will see the side effects of cannabis use with greater frequency...
October 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#16
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049113/the-us-opioid-crisis-current-federal-and-state-legal-issues
#17
REVIEW
Cobin D Soelberg, Raeford E Brown, Derick Du Vivier, John E Meyer, Banu K Ramachandran
The United States is in the midst of a devastating opioid misuse epidemic leading to over 33,000 deaths per year from both prescription and illegal opioids. Roughly half of these deaths are attributable to prescription opioids. Federal and state governments have only recently begun to grasp the magnitude of this public health crisis. In 2016, the Centers for Disease Control and Prevention released their Guidelines for Prescribing Opioids for Chronic Pain. While not comprehensive in scope, these guidelines attempt to control and regulate opioid prescribing...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29045260/encopresis-plus
#18
DePorres Cormier, Marie Reilly, Amy Young, Marilyn Augustyn
Dexter is a 12-year-old boy who presents with his maternal grandmother for follow-up to primary care for secondary encopresis. Dexter presented, 18 months ago, with a 3-month history of secondary encopresis. At that time, a comprehensive assessment revealed functional constipation resulting in encopresis. Dexter's symptoms resolved with a combination of medication management and behavioral strategies; laxatives were discontinued 12 months ago.Dexter's grandmother reports that for the past 6 months, her grandson developed encopresis once again...
November 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/29016917/cannabis-for-the-treatment-of-chronic-pain-in-the-era-of-an-opioid-epidemic-a-symposium-based-review-of-sociomedical-science
#19
Dermot P Maher, Daniel B Carr, Kevin Hill, Brian McGeeney, Valerie Weed, William C Jackson, David J DiBenedetto, Edward M Moriarty, Ronald J Kulich
Objective: This manuscript reviews medical literature published pertaining to the management of chronic pain with medical marijuana therapy (MMJ), with an emphasis on the social, medical, and legal aspects of therapy. Design: Narrative review of peer-reviewed literature. Methods: The 3rd Symposium on Controlled Substances and Their Alternatives for the Treatment of Pain was held in Boston on February 27, 2016, with a focus on MMJ for the treatment of chronic pain...
July 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28987529/a-novel-approach-in-the-treatment-of-acute-whiplash-syndrome-ultrasound-guided-needle-percutaneous-electrolysis-a-randomized-controlled-trial
#20
J García Naranjo, S Barroso Rosa, J F Loro Ferrer, J M Limiñana Cañal, E Suarez Hernández
INTRODUCTION: Whiplash associated disorders are currently a common musculoskeletal problem. Besides the high incidence in western countries, the costs derived from prolonged treatment and medicolegal compensation, make this entity a challenging problem for clinicians and insurance companies. To date, no conservative treatment has shown clear superiority in the management of acute cases. HYPOTHESIS: Percutaneous needle electrolysis (PNE) is an effective approach for the treatment of Quebec type II acute whiplash syndrome (AWS)...
December 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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