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https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#1
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/28918904/comparison-of-laser-doppler-imaging-ldi-and-clinical-assessment-in-differentiating-between-superficial-and-deep-partial-thickness-burn-wounds
#2
Saadia Nosheen Jan, Farid Ahmed Khan, Muhammad Mustehsan Bashir, Muneeb Nasir, Hamid Hussain Ansari, Hussan Birkhez Shami, Umer Nazir, Asif Hanif, Muhammad Sohail
PURPOSE OF PRESENTATION/STUDY: To compare the accuracy of Laser Doppler Imaging (LDI) and clinical assessment in differentiating between superficial and deep partial thickness burns to decide whether early tangential excision and grafting or conservative management should be employed to optimize burn and patient management. STUDY PERIOD: March 2015 to November 2016. METHODS/PROCEDURE DETAILS: Ninety two wounds in 34 patients reporting within 5days of less than 40% burn surface area were included...
September 14, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28916849/1000-consecutive-cases-of-laser-assisted-liposuction-utilizing-the-1440%C3%A2-nm-wavelength-nd-yag-laser-assessing-the-safety-and-efficacy
#3
Christopher T Chia, Mark G Albert, Sharon Del Vecchio, Spero J Theodorou
BACKGROUND: Liposuction remains one of the most popular aesthetic surgery procedures performed today, and it has undergone continuous refinements over the past four decades. Advancements in anesthesia, improvements in instrumentation, better understanding of fluid dynamics and the addition of energy to liposuction have led to better outcomes with improved safety and efficacy. OBJECTIVES: The purpose of this study is to review 1000 consecutive laser-assisted liposuction (LAL) cases utilizing the 1440 nm wavelength...
September 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28905128/women-s-subjective-experiences-of-living-with-vulvodynia-a-systematic-review-and-meta-ethnography
#4
Rebekah Shallcross, Joanne M Dickson, David Nunns, Catharine Mackenzie, Gundi Kiemle
Vulvodynia, the experience of an idiopathic pain in the form of burning, soreness, or throbbing in the vulval area, affects around 4-16% of the population. The current review used systematic search strategies and meta-ethnography as a means of identifying, analyzing, and synthesizing the existing literature pertaining to women's subjective experiences of living with vulvodynia. Four key concepts were identified: (1) Social Constructions: Sex, Women, and Femininity: Women experienced negative consequences of social narratives around womanhood, sexuality, and femininity, including the prioritization of penetrative sex, the belief that it is the role of women to provide sex for men, and media portrayals of sex as easy and natural...
September 13, 2017: Archives of Sexual Behavior
https://www.readbyqxmd.com/read/28902702/assessment-and-management-of-burn-pain-at-the-komfo-anokye-teaching-hospital-a-best-practice-implementation-project
#5
Jonathan Bayuo, Zachary Munn, Jared Campbell
BACKGROUND: Pain management is a significant issue in health facilities in Ghana. For burn patients, this is even more challenging as burn pain has varied facets. Despite the existence of pharmacological agents for pain management, complaints of pain still persist. OBJECTIVES: The aim of this project was to identify pain management practices in the burns units of Komfo Anokye Teaching Hospital, compare these approaches to best practice, and implement strategies to enhance compliance to standards...
September 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28902290/effect-of-secondary-infection-on-epithelialisation-and-total-healing-of-cutaneous-leishmaniasis-lesions
#6
Liliane de Fátima Antonio, Marcelo Rosandiski Lyra, Maurício Naoto Saheki, Armando de Oliveira Schubach, Luciana de Freitas Campos Miranda, Maria de Fátima Madeira, Maria Cristina da Silva Lourenço, Aline Fagundes, Érica Aparecida Dos Santos Ribeiro, Leonardo Barreto, Maria Inês Fernandes Pimentel
BACKGROUND: Cutaneous leishmaniasis (CL) generally presents with a single or several localised cutaneous ulcers without involvement of mucous membranes. Ulcerated lesions are susceptible to secondary contamination that may slow the healing process. OBJECTIVE: This study verified the influence of non-parasitic wound infection on wound closure (epithelialisation) and total healing. METHODS: Twenty-five patients with a confirmed diagnosis of CL and ulcerated lesions underwent biopsy of ulcer borders...
September 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/28898193/molecular-breast-imaging-in-breast-cancer-screening-and-problem-solving
#7
Robin B Shermis, Roberta E Redfern, Jessica Burns, Haris Kudrolli
In the United States, legislative actions in over 28 states require radiologists to notify women who undergo breast screening mammography of their breast density. This has led to increased public interest in supplemental screening, but radiologists have not come to a consensus on a supplemental screening modality. In choosing between the most common options, whole-breast ultrasonography (US) and magnetic resonance (MR) imaging, one must weigh the benefits and drawbacks of each modality, as increased cancer detection may be accompanied by increased examination costs and biopsy rates...
September 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28894374/predicting-and-managing-sepsis-in-burn-patients-current-perspectives
#8
Omar Nunez Lopez, Janos Cambiaso-Daniel, Ludwik K Branski, William B Norbury, David N Herndon
Modern burn care has led to unprecedented survival rates in burn patients whose injuries were fatal a few decades ago. Along with improved survival, new challenges have emerged in the management of burn patients. Infections top the list of the most common complication after burns, and sepsis is the leading cause of death in both adult and pediatric burn patients. The diagnosis and management of sepsis in burns is complex as a tremendous hypermetabolic response secondary to burn injury can be superimposed on systemic infection, leading to organ dysfunction...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28893016/comparison-of-intubating-conditions-using-fentanyl-plus-propofol-versus-fentanyl-plus-midazolam-during-fiberoptic-laryngoscopy
#9
Parmod Kumar, Tripat Kaur, Gurpreet Kaur Atwal, Jatinderpaul Singh Bhupal, Ajay Kumar Basra
INTRODUCTION: Awake nasal or oral flexible fiberoptic intubation is the airway management technique of choice in known or anticipated difficult airway, unstable cervical fracture, limited mouth opening (as in temporomandibular joint disease), mandibular-maxillary fixation and severe facial burns. Both optimal intubating condition and patient comfort are important for fiberoptic intubation. Optimal intubating conditions provided by an ideal sedation regimen would ensure haemodynamic stability, patient comfort, attenuation of airway reflexes and amnesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28888319/systems-based-practice-in-burn-care-prevention-management-and-economic-impact-of-health-care-associated-infections
#10
REVIEW
Charles Scott Hultman, David van Duin, Emily Sickbert-Bennett, Lauren M DiBiase, Samuel W Jones, Bruce A Cairns, David J Weber
Health care-associated infections in burn patients, from ventilator-associated pneumonia to skin and soft tissue infections, can substantially compromise outcomes, because these complications are associated with longer lengths of stay, increased morbidity and mortality, and greater direct medical costs. Health care-associated infections are largely preventable, through surveillance, education, appropriate hand hygiene, and culture change, especially for device-related infections. Systems-based practice, which allows individuals and clinical microsystems to navigate and improve the macro health care system, may be one of the most powerful skill sets to effect change, permitting a shift in culture toward patient safety and quality improvement...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888318/under-pressure-applying-practice-based-learning-and-improvement-to-the-treatment-of-chronic-neuropathic-pain-in-patients-with-burns
#11
REVIEW
Mihaela Rapolti, Cindy Wu, Olga A Schuth, Charles Scott Hultman
Chronic neuropathic pain after burn injury may have multiple causes, such as direct nerve injury, nerve compression, or neuroma formation, and can significantly impair quality of life and limit functional recovery. Management includes a team-based approach that involves close collaboration between occupational and physical therapists, plastic surgeons, and experts in chronic pain, from neurology, anesthesia, psychiatry, and physiatry. Carefully selected patients with an anatomic cause of chronic neuropathic pain unequivocally benefit from surgical intervention...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888312/burn-management-in-the-developing-world-international-volunteerism
#12
REVIEW
Anne Argenta, Jack Demos
The burden of burn injury falls predominantly on the world's poor, with low-income and middle-income countries accounting for 96% of burn injuries. These vulnerable populations are the least likely to have access to adequate medical care and are the most reliant on volunteer organizations. Every underserved area has a unique set of needs, circumstances, customs, resources, and challenges. The authors' intent is to provide an additional resource for volunteer surgeons who are interested in treating burns. This article reviews planning, organizing, and participating in a burn surgical mission trip...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888309/head-and-neck-reconstruction
#13
REVIEW
Shannon Wong, Alyson Melin, Debra Reilly
Management of head and neck burns involves acute and intermediate phases. Acutely, the goals are establish a secure airway and treat life-threatening injuries. Then, optimize nutrition, assess extent of the burn, perform local wound care, and provide eye protection. Management depends on the degree of the head and neck burn. Postinjury splinting and rehabilitation are vital to healing. After the acute inflammation has resolved and the scars have matured, reconstruction begins with the goals of restoring both function and aesthetics...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888308/hand-reconstruction-after-burn-injury-functional-results
#14
REVIEW
Günter Germann
Frequently burns of the hand occur as part of a major thermal injury, but appropriate treatment of the hands has high priority, because even small burns of the hand may result in severely limited function and compromised aesthetic appearance. The functional importance of the hand cannot be overemphasized, because the patient's ability to perform useful work after recovery or the ability to care for themselves is to a great degree determined by residual hand function. This article describes the management of burn injuries involving the hand, stressing the importance of appropriate initial treatment...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888303/fat-grafting-for-burn-traumatic-and-surgical-scars
#15
REVIEW
Rafi Fredman, Adam J Katz, Charles Scott Hultman
Fat grafting provides a reliable modality with expanding usefulness in reconstructive plastic surgery. Owing to its mechanical and theorized regenerative properties, adipose tissue can improve scar qualities and scar related symptoms when grafted adjacent to or within a scar. In this article, the literature describing the effect of fat grafting on various types of scars, current scientific understanding of fat grafting for scars, and our current approach to the management of problematic burn scars are reviewed...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888301/laser-modulation-of-hypertrophic-scars-technique-and-practice
#16
REVIEW
Andrea C Issler-Fisher, Jill S Waibel, Matthias B Donelan
In this review, the authors discuss the use of laser photothermolysis and laser resurfacing in the management of hypertrophic burn scars. They provide details regarding preoperative selection, intraoperative decision making, and postoperative care.
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888300/heterotopic-ossification-and-hypertrophic-scars
#17
REVIEW
Shailesh Agarwal, Michael Sorkin, Benjamin Levi
Burns and trauma cause superficial and deep soft tissue wounds that cannot heal to the preinjury state. Healing requires cell proliferation and differentiation into the injured tissue type, laying down extracellular matrix, often as collagens. Heterotopic ossification causes severe pain, nonhealing wounds, and restricted range of motion. Treatment includes radiation therapy, nonsteroidal anti-inflammatory drugs, bisphosphonates, and possibly surgical excision and prophylactic measures. Hypertrophic scars, nonosseous lesions caused by excessive collagen deposition, are often painful, functionally limiting, and aesthetically displeasing...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888299/principles-of-burn-pain-management
#18
REVIEW
Dominika Lipowska James, Maryam Jowza
This article describes pathophysiology of burn injury-related pain and the basic principles of burn pain management. The focus is on concepts of perioperative and periprocedural pain management with extensive discussion of opioid-based analgesia, including patient-controlled analgesia, challenges of effective opioid therapy in opioid-tolerant patients, and opioid-induced hyperalgesia. The principles of multimodal pain management are discussed, including the importance of psychological counseling, perioperative interventional pain procedures, and alternative pain management options...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888297/current-concepts-burn-rehabilitation-part-ii-long-term-recovery
#19
REVIEW
Heather Dodd, Sandra Fletchall, Carrie Starnes, Keith Jacobson
This article summarizes current interventions for several of the most common challenges faced by patients during their rehabilitation from burn injury. These challenges include range of motion preservation through scar contracture management, achieving maximal independence through exercise and activities of daily living training, and psychological recovery through nonpharmacologic approaches pain and anxiety.
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28888296/current-concepts-burn-rehabilitation-part-i-care-during-hospitalization
#20
REVIEW
Keith Jacobson, Sandra Fletchall, Heather Dodd, Carrie Starnes
This article summarizes current interventions for several of the most common challenges faced by patients during their rehabilitation from burn injury. These include preservation of range of motion through scar contracture management, and achieving maximal independence through exercise, and training in activities of daily living.
October 2017: Clinics in Plastic Surgery
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