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Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
BACKGROUND AND IMPORTANCE: As the use of flow-diverting stents (FDSs) for intracranial aneurysms expands, a small number of case reports have described the successful treatment of blister aneurysms of the internal carotid artery with flow diversion. Blister aneurysms are uncommon and fragile lesions that historically have high rates of morbidity and mortality despite multiple treatment strategies. We report a case of rebleeding after treatment of a ruptured blister aneurysm with deployment of a single FDS...
November 2016: Neurosurgery
Sandeep Kumar, Gerald Pflueger
Femoral nerve neuropathy after total hip arthroplasty is rare but catastrophic complication. Pain and quadriceps muscle weakness caused by this complication can significantly affect the functional outcome. Here we present a case report, describing delayed onset femoral nerve palsy associated with iliopsoas hematoma following pseudoaneurysm of a branch of profunda femoris artery after 3 months of primary total hip arthroplasty in an 80-year-old female patient with single kidney. Hip arthroplasty was done for painful primary osteoarthritis of left hip...
2016: Case Reports in Orthopedics
Craig Ravesloot, Cathy Berendts, Alex Schiwal
BACKGROUND: Measurement of the environment is taking on increased importance for understanding variability in participation. Most measures of the environment use subjective ratings, yet little is known about how people appraise the environment. OBJECTIVE: /Hypothesis: We conducted this post-hoc study to examine whether or not catastrophizing, an important variable for understanding how pain contributes to disability, may be related to ratings of the environment...
October 5, 2016: Disability and Health Journal
Nikola Dobrilovic, Peter Soukas, Immad Sadiq, Lisa Goldstein, Jaishankar Raman
BACKGROUND: The CorMatrix (CorMatrix Cardiovascular, Roswell, Ga) biologic extracellular patch derived from porcine small intestinal mucosa provides a biologic scaffold for cellular ingrowth and eventual tissue regeneration. It has been used in a variety of applications, including cardiac and vascular repair procedures. METHODS: CorMatrix was used as a patch arterioplasty for femoral artery repair in conjunction with endarterectomy for seven separate procedures in six patients (one patient underwent staged, bilateral femoral procedures)...
October 14, 2016: Journal of Vascular Surgery
Shegu Gilbert, Devender Singh, M Lawrance Jesuraj
Severe QT interval prolongation >500ms occurs in one quarter of cardiac surgical patients in the perioperative period while moderate prolongation occurs in most of them. Prolonged QT interval may be associated with torsades de pointes and lead to sudden cardiac death. Because of the high incidence of prolonged QT in cardiac surgery patients and its perioperative adverse outcomes, it is vital to identify it early and take necessary precautions. We report and discuss the catastrophic events and management of two patients with long QT syndrome complicating mitral valve replacement...
September 2016: Indian Heart Journal
Anne Llewellyn
Life-changing illness or experiencing a catastrophic injury changes one's outlook on life. This is a story of one case manager's journey.
November 2016: Professional Case Management
Michael J Alfonzo, Carl R Baum
Magnets are inherently attractive to young children, but present a risk when ingested. If consumed alone, small, smooth magnetic foreign bodies are likely to pass without significant event; however, ingestion of multiple magnets may have catastrophic consequences, including bowel perforation, obstruction, peritonitis, and death. Increasing reports of morbidity and mortality in recent years from the US National Electronic Injury Surveillance System has led to numerous safety statements from the American Academy of Pediatrics and the Centers for Disease Control and Prevention, as well as several product recalls from the Consumer Product Safety Commission...
October 2016: Pediatric Emergency Care
Dmitri Bezinover, Shigekazu Sugino, Yuka Imamura-Kawasawa, Matthew S Bell, Zakiyah Kadry, Piotr K Janicki
We describe a case of fulminant intraoperative thrombosis during deceased donor liver transplantation. Despite significant medical bleeding, the patient suddenly developed diffuse thrombosis in all chambers of the heart and pulmonary vasculature resulting in intraoperative death. The patient's postmortem genetic analysis demonstrated a deleterious missense mutation in a coagulation pathway gene, SERPINC1, which codes for antithrombin III. The level of antithrombin III was not available to directly prove the causality of thrombosis, but our findings suggest that this mutation, in combination with antifibrinolytic administration in a hypercoagulable cirrhotic patient, might have contributed to the development of this catastrophic thrombotic event...
October 5, 2016: A & A Case Reports
Victor Grech, Dorota Zammit, Hagen Scherb
Males are usually born in excess of females. The sex ratio at birth (SR) is often expressed as the ratio of male to total births. A wide variety of factors have been shown to influence SR, including terrorist attacks, which have been shown to reduce SR. This paper reviews the effects on SR outcomes of the stressful events in France in 1968 (in association with the student and worker riots) and in Japan following the Aum Shinrikyo religious cult's attack on the Tokyo subway using sarin nerve gas in 1995. Both countries displayed seasonal variation in SR...
October 17, 2016: Journal of Biosocial Science
Anne M Boonstra, Roy E Stewart, Albère J A Köke, René F A Oosterwijk, Jeannette L Swaan, Karlein M G Schreurs, Henrica R Schiphorst Preuper
Objectives: The 0-10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the variability of the optimal cut-off points, and to determine the influence of patients' catastrophizing and their sex on these cut-off points. Methods: 2854 patients were included. Pain was assessed by the NRS, functioning by the Pain Disability Index (PDI) and catastrophizing by the Pain Catastrophizing Scale (PCS)...
2016: Frontiers in Psychology
Vani A Mathur, Massieh Moayedi, Michael L Keaser, Shariq A Khan, Catherine S Hubbard, Madhav Goyal, David A Seminowicz
Migraine is a pain disorder associated with abnormal brain structure and function, yet the effect of migraine on acute pain processing remains unclear. It also remains unclear whether altered pain-related brain responses and related structural changes are associated with clinical migraine characteristics. Using fMRI and three levels of thermal stimuli (non-painful, mildly painful, and moderately painful), we compared whole-brain activity between 14 migraine patients and 14 matched controls. Although, there were no significant differences in pain thresholds nor in pre-scan pain ratings to mildly painful thermal stimuli, patients did have aberrant suprathreshold nociceptive processing...
2016: Frontiers in Human Neuroscience
Joaquín Valle Alonso, Francisco Javier Fonseca Del Pozo, Manuel Vaquero Álvarez, Jorge Pedraza, Miguel Angel Aguayo, Almudena Sanchez
Acquired thrombotic and thromboembolic disorders may be presented initially with symptoms and signs of acute ischaemia or organ dysfunction that will lead many of these patients to seek care in the emergency department. We report a case of a 19-year-old female patient who developed catastrophic antiphospholipid syndrome (CAPS syndrome or Asherson syndrome) 6 weeks post stillbirth with an initial presentation of acute vascular occlusion. The patient was immediately operated and anticoagulated with significant improvement...
October 10, 2016: Reumatología Clinica
Chase L Andreason, Timothy H Pohlman
The timely recognition of shock secondary to hemorrhage from severe facial trauma or as a complication of complex oral and maxillofacial surgery presents formidable challenges. Specific hemostatic disorders are induced by hemorrhage and several extreme homeostatic imbalances may appear during or after resuscitation. Damage control resuscitation has evolved from massive transfusion to a more complex therapeutic paradigm that includes hemodynamic resuscitation, hemostatic resuscitation, and homeostatic resuscitation...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
Hsiang-I Wang, Giou-Teng Yiang, Chin-Wang Hsu, Jen-Chun Wang, Chien-Hsing Lee, Yu-Long Chen
BACKGROUND: Thyroid storm, an endocrine emergency, remains a diagnostic and therapeutic challenge. It is recognized to develop as a result of several factors, including infection, surgery, acute illness, and rarely, trauma. Recognition of thyroid storm in a trauma patient is difficult because the emergency physician usually focuses on managing more obvious injuries. OBJECTIVE OF THE REVIEW: We present a case of trauma-related thyroid storm and review the previous literature on posttraumatic thyroid storm to delineate risk factors of the disease...
October 11, 2016: Journal of Emergency Medicine
Fernando Rafael Barri
Wildlife reintroduction is an increasingly used strategy to reverse anthropocene defaunation. For the purpose of ecosystem restoration, in 2007 the guanaco (Lama guanicoe) was reintroduced to the Quebrada del Condorito National Park, situated in the mountains of central Argentina. With the aim of developing management recommendations, the project included permanently monitoring the population to evaluate its dynamics and the ecological response of the individuals released into the area. Nine years later and after two releases of guanacos (113 individuals in 2007 without and 25 in 2011 with a pre-adaptation period), only 24 individuals, which conform three reproductive groups, and one group of solitary males were settled in the Park...
2016: PloS One
S Kettemann
We consider the orthogonality catastrophe at the Anderson metal-insulator transition (AMIT). The typical overlap F between the ground state of a Fermi liquid and the one of the same system with an added potential impurity is found to decay at the AMIT exponentially with system size L as F∼exp(-cL^{η}), where η is the power of multifractal intensity correlations. Thus, strong disorder typically increases the sensitivity of a system to an added impurity exponentially. We recover, on the metallic side of the transition, Anderson's result that the fidelity F decays with a power law F∼L^{-q(E_{F})} with system size L...
September 30, 2016: Physical Review Letters
P M Derlet, R Maaß
The statistics and origin of the first discrete plastic event in a one-dimensional dislocation dynamics simulation are studied. This is done via a linear stability analysis of the evolving dislocation configuration up to the onset of irreversible plasticity. It is found that, via a fold catastrophe, the dislocation configuration prior to loading directly determines the stress at which the plastic event occurs and that between one and two trigger dislocations are involved. The resulting irreversible plastic strain arising from the instability is found to be highly correlated with these triggering dislocations...
September 2016: Physical Review. E
R Whittle, G Mansell, P Jellema, D van der Windt
BACKGROUND: Many randomized controlled trials (RCTs) of psychosocial interventions for low back pain (LBP) have been found to have only small effects on disability outcomes. Investigations of the specific mechanisms that may lead to an improvement in outcome have therefore been called for. METHODS: We present an application of the causal inference approach to mediation analysis using the example of a cluster RCT in a primary care population with (sub)acute LBP randomized to either usual GP care (n = 171) or a minimal psychosocial intervention (n = 143)...
October 14, 2016: European Journal of Pain: EJP
G P Bostick, S J Kamper, T M Haanstra, B D Dick, L W Stitt, P Morley-Forster, A J Clark, M E Lynch, A Gordon, H Nathan, C Smyth, M A Ware, C Toth, D E Moulin
BACKGROUND: Pain expectancy may be an important variable that has been found to influence the effectiveness of treatments for pain. Much of the literature supports a self-fulfilment perspective where expectations for pain relief predict the actual pain experienced. However, in conditions such as neuropathic pain (NeP) where pain relief is difficult to attain, expectations for pain relief could be unrealistic. The objective of this study was to investigate the relationship between realistic/unrealistic expectations and 6-month, post-treatment outcomes...
October 14, 2016: European Journal of Pain: EJP
Daniel S Hill, Kuntal Patel, Deepak Herlekar
BACKGROUND: Highly cross-linked polyethylene in total hip arthroplasty (THA) has been shown to decrease wear rate compared with a conventional polyethylene liner. However, it has also been reported that the manufacturing processes can cause early failure of the implant. CASE: We describe early catastrophic failure at <4 years following primary THA surgery of a PINNACLE MARATHON® polyethylene acetabular liner resulting from a malaligned PINNACLE DUOFIX HA® acetabular shell with resultant point loading...
October 13, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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