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https://www.readbyqxmd.com/read/29331965/right-iliac-fossa-pain-treatment-rift-study-protocol-for-an-international-multicentre-prospective-observational-study
#1
Dmitri Nepogodiev
INTRODUCTION: Patients presenting with right iliac fossa (RIF) pain are a common challenge for acute general surgical services. Given the range of potential pathologies, RIF pain creates diagnostic uncertainty and there is subsequent variation in investigation and management. Appendicitis is a diagnosis which must be considered in all patients with RIF pain; however, over a fifth of patients undergoing appendicectomy, in the UK, have been proven to have a histologically normal appendix (negative appendicectomy)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29323836/segmental-arterial-mediolysis-an-unusual-case-mistaken-to-be-a-strangulated-hernia
#2
Russell D Japikse, James E Sevenson, Perry J Pickhardt, Michael D Repplinger
INTRODUCTION: Segmental arterial mediolysis (SAM) is a rare nonatherosclerotic, noninflammatory vasculopathy causing arterial wall necrosis that leads to strictures, dissections, and aneurysms, particularly in medium-sized abdominal arteries. Awareness of SAM is important because, unlike vasculitides, immunosuppressive treatment may worsen the disease process. CASE: A 58-year-old man with multiple medical comorbidities presented with acute epigastric pain and a right incarcerated inguinal hernia that was interpreted as showing bowel strangulation on computed tomography...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29316995/prehospital-modified-heart-score-predictive-of-30-day-adverse-cardiac-events
#3
Jason P Stopyra, William S Harper, Tyson J Higgins, Julia V Prokesova, James E Winslow, Robert D Nelson, Roy L Alson, Christopher A Davis, Gregory B Russell, Chadwick D Miller, Simon A Mahler
Introduction The History, Electrocardiogram (ECG), Age, Risk Factors, and Troponin (HEART) score is a decision aid designed to risk stratify emergency department (ED) patients with acute chest pain. It has been validated for ED use, but it has yet to be evaluated in a prehospital setting. Hypothesis A prehospital modified HEART score can predict major adverse cardiac events (MACE) among undifferentiated chest pain patients transported to the ED. METHODS: A retrospective cohort study of patients with chest pain transported by two county-based Emergency Medical Service (EMS) agencies to a tertiary care center was conducted...
January 10, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29313105/-nursing-pain-experts-in-german-hospitals-a-compilation-of-activity-profiles-and-tasks
#4
R Boche, N Nestler, J Erlenwein, E Pogatzki-Zahn
BACKGROUND: In recent years nurses have come to play a professional role in pain management. In Germany, the publication of the national expert standards on pain management in nursing resulted in nurses being educated to be pain resource nurses; however, since education has started the continuance and commitments of specialized pain nurses in clinical practice is basically unclear. The goal of this evaluation was to identify how pain resource nurses are involved in pain management and organizational aspects in German hospitals...
January 8, 2018: Der Schmerz
https://www.readbyqxmd.com/read/29302540/a-chart-review-of-morbidity-patterns-among-adult-patients-attending-primary-care-setting-in-urban-odisha-india-an-international-classification-of-primary-care-experience
#5
Subhashisa Swain, Sandipana Pati, Sanghamitra Pati
Introduction: Disease burden estimations based on sound epidemiological research provide the foundation for designing health services. Patients visiting a primary care often present with symptoms and signs. Understanding the burden is crucial for developing countries including India. The project aimed to record the reasons for encounter (RFE) at primary care settings for estimating the burden at the health-care facility. Methodology: This cross-sectional study was undertaken at four urban health dispensaries of Bhubaneswar, Odisha, with the aim to explore the prevailing patterns of diseases among patients attending these facilities...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29300785/management-of-minor-ailments-in-a-community-pharmacy-setting-findings-from-simulated-visits-and-qualitative-study-in-gondar-town-ethiopia
#6
Asnakew Achaw Ayele, Abebe Basazn Mekuria, Henok Getachew Tegegn, Begashaw Melaku Gebresillassie, Alemayehu Birhane Mekonnen, Daniel Asfaw Erku
Community pharmacy professionals are being widely accepted as sources of treatment and advice for managing minor ailments, largely owing to their location at the heart of the community. The aim of the present study was, therefore, to document the involvement of community pharmacy professionals in the management of minor ailments and perceived barriers that limit their provision of such services. Simulated patient (SP) visits combined with a qualitative study using in-depth interviews was conducted among community pharmacy professionals in Gondar town, Northwest Ethiopia...
2018: PloS One
https://www.readbyqxmd.com/read/29287695/pain-treatments-after-hip-fracture-among-older-nursing-home-residents
#7
Andrew R Zullo, Tingting Zhang, Francesca L Beaudoin, Yoojin Lee, Kevin W McConeghy, Douglas P Kiel, Lori A Daiello, Vincent Mor, Sarah D Berry
OBJECTIVES: To examine the association between use of opioids versus other analgesics with death and functioning after hip fracture in older nursing home (NH) residents. DESIGN: Retrospective cohort using national Medicare fee-for-service claims linked to the Minimum Data Set. SETTING: US NHs. PARTICIPANTS: NH residents aged ≥65 years who became a long-stay resident (>100 days in the NH) between January 2008 and December 2009, had a hospitalized hip fracture, and returned to the NH...
December 26, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29276258/lumbar-spine-surgeries-and-medication-usage-during-hospital-stay-one-center-perspective
#8
Neena K Sharma, Busuyi Olotu, Asha Mathew, Lemuel R Waitman, Rafia Rasu
Background: Pain after spine surgery is usually managed with opioid and nonopioids. The rate of lumbar spine surgeries (LSS) is rising, but current practices on LSS are not known. A current trend in LSS and medication usage by age group is needed to gain a better understanding of how LSS and its pain management vary by age. Objective: The aim of this study was to report current practices of LSS of discectomy, laminectomy, and fusion in patients aged 18 and older and to gain an understanding of medication use for management of LSS...
December 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29223194/hospital-confirmed-acute-myocardial-infarction-prehospital-identification-using-the-medical-priority-dispatch-system
#9
Jeff J Clawson, Isabel Gardett, Greg Scott, Conrad Fivaz, Tracey Barron, Meghan Broadbent, Christopher Olola
Introduction Early recognition of an acute myocardial infarction (AMI) can increase the patient's likelihood of survival. As the first point of contact for patients accessing medical care through emergency services, emergency medical dispatchers (EMDs) represent the earliest potential identification point for AMIs. The objective of the study was to determine how AMI cases were coded and prioritized at the dispatch point, and also to describe the distribution of these cases by patient age and gender. Hypothesis/Problem No studies currently exist that describe the EMD's ability to correctly triage AMIs into Advanced Life Support (ALS) response tiers...
December 10, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29222301/optimizing-the-care-model-for-an-uncomplicated-acute-pain-episode-in-sickle-cell-disease
#10
REVIEW
Paul Telfer, Banu Kaya
The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29218817/impact-of-a-shared-decision-making-intervention-on-healthcare-utilization-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#11
Jason T Schaffer, Erik P Hess, Judd E Hollander, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Jonathan Inselman, Jeph Herrin, Victor M Montori, Nilay D Shah
BACKGROUND: Patients at low risk for acute coronary syndrome (ACS) are frequently admitted for observation and cardiac testing, resulting in substantial burden and cost to the patient and the healthcare system. OBJECTIVES: The purpose of this investigation was to measure the effect of the Chest Pain Choice decision aid (CPC) on overall healthcare utilization as well as utilization of specific services both during the index emergency department visit and in the subsequent 45 days...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29192644/automated-centrifugal-therapeutic-plasma-exchange-option-for-guillain-barre-syndrome-a-report-from-calabar-nigeria
#12
O E Iheanacho, C Chimeziem, B S Sachais, P A Shi
Therapeutic plasma exchange (TPE) is performed frequently and effectively in developed countries, whereas the reverse is the case in developing countries. Guillain-Barre syndrome (GBS), synonymous with acute inflammatory demyelinating polyneuropathy, is an important indication for TPE, but this is rarely administered in the treatment of such patients in Nigeria due to lack of such automated facility, limited expertise, and high cost. This report therefore presents an uncommon case of GBS in which automated TPE was utilized in the management, with the aims of highlighting the current status and challenges of therapeutic apheresis services in Nigeria...
October 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29180543/multiple-practical-facts-and-ideas-to-improve-family-medicine-care
#13
EDITORIAL
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Seconds count in a study on the best electronic health note format to reduce medical record charting time and increase accuracy. Directly observed family physician work is compared with Current Procedural Terminology (CPT) coding examples and notably under-recognized. This issue contains articles from single practices that that implemented new methods of care and other reports on practice innovations that can be more broadly implemented. We have articles on opioid medication use for acute low back pain in primary care, an electronic chronic pain consult service, a key question to identify potential opioid misuse risk, and newly implemented screening for other substances of abuse...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29150727/measuring-emotional-intelligence-enhances-the-psychological-evaluation-of-chronic-pain
#14
Eva M Doherty, Rosemary Walsh, Leanne Andrews, Susan McPherson
The assessment of emotional factors, in addition to other psychosocial factors, has been recommended as a means of identifying individuals with chronic pain who may not respond to certain pain treatments. Systematic reviews of the evidence regarding the prediction of responsiveness to a treatment called the spinal cord stimulator (SCS) have yielded inconclusive results. Emotional intelligence is a term which refers to the ability to identify and manage emotions in oneself and others and has been shown to be inversely associated with emotional distress and acute pain...
December 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29150470/platelet-rich-plasma-in-achilles-tendon-healing-2-path-2-trial-protocol-for-a-multicentre-participant-and-assessor-blinded-parallel-group-randomised-clinical-trial-comparing-platelet-rich-plasma-prp-injection-versus-placebo-injection-for-achilles-tendon-rupture
#15
Joseph Alsousou, David J Keene, Philippa A Hulley, Paul Harrison, Susan Wagland, Christopher Byrne, Michael Maia Schlüssel, Susan J Dutton, Sarah E Lamb, Keith Willett
BACKGROUND: Achilles tendon injuries give rise to substantial long-lasting morbidity and pose considerable challenges for clinicians and patients during the lengthy healing period. Current treatment strategies struggle to curb the burden of this injury on health systems and society due to lengthy rehabilitation, work absence and reinjury risk. Platelet-rich plasma (PRP) is an autologous preparation that has been shown to improve the mechanobiological properties of tendons in laboratory and animal studies...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#16
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29109872/severe-decompression-illness-case-report-prehospital-recognition-and-regional-transport-considerations
#17
Julie Estrada, David Meurer, Kevin De Boer, Karl Huesgen
A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29106649/pain-management-for-primary-care-providers-a-narrative-review-of-high-impact-studies-2014-2016
#18
William C Becker, Matthew J Bair, Michael Picchioni, Joanna L Starrels, Joseph W Frank
Objective: This manuscript reviews high-impact, peer-reviewed studies published from January 2014 to March 2016 that are relevant to pain management in primary care. Given the recent release of the US Centers for Disease Control and Prevention's "Guideline for Prescribing Opioids for Chronic Pain" emphasizing the primacy of nonopioid treatment, we focused our review on nonopioid pain management. Design: Narrative review of peer-reviewed literature. Methods: We searched three article summary services and queried expert contacts for high-impact, English-language studies related to the management of pain in adults in primary care...
July 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29103573/practical-management-of-a-regional-anesthesia-driven-acute-pain-service
#19
REVIEW
Stephen F Goldberg, John-Paul J Pozek, Eric S Schwenk, Jaime L Baratta, David H Beausang, Andrew K Wong
No abstract text is available yet for this article.
2017: Advances in Anesthesia
https://www.readbyqxmd.com/read/29098095/medical-approach-to-right-colon-diverticulitis-with-perforation
#20
James Espinosa, Rahul Sharma, Alan Lucerna, Doug Stranges
We report a case of a 71-year-old female who presented with right lower quadrant (RLQ) abdominal pain and was diagnosed on CT scan with right-sided diverticulitis with perforation. She was admitted under the surgical service after consultation and received intravenous fluids, intravenous antibiotics, and pain medications as needed. The patient was discharged 2 days after admission in stable condition with follow-up with gastroenterology. The differential diagnosis of right lower quadrant abdominal pain is vast...
2017: Case Reports in Emergency Medicine
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